Life @fter Diagnosis

Legal Issues

The information presented in this file should NOT be considered legal or medical advice. No additions or changes in treatment should be considered without consulting your physician first and always talk to your legal advisors before signing any docume nts.

When choosing legal advise

ALWAYS make sure your attorney has extensive legal expertise with cases similar to yours

Google their names to make sure they are not involved in any claims or dubious activities
Make sure they have spent enough time in your county of residence if they are out of town

Ask ahead of time the difference between charging a percentage of the total value of the Estate vs. billing you by the hour
Make sure you understand which assets should go to probate and which should not (co-titled properties and joint bank accounts should not). Ask also about how the Executor fees could change depending on which assets go to probate Get an Accountant to help you with the numbers The following downloadable forms have been approved by the Supreme Court of Florida: Florida Living Will Florida Health Care Surrogate

To learn more about Legal documents, check the local Bar Association. In Florida, check Powers of Attorney Pamphlet If you decided to fire your lawyer (as suggested by the Fl Bar) write a letter describing your reasons for termination and send it certified mail, return receipt requested. Also, request a copy of your file, an itemized bill, and return of any property or unearned fee. Your lawyer is entitled to be paid any fees that are earned and unpaid and any costs that have been advanced, and may be entitled to assert a lien on the file until those sums have been paid.

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To make sure you are legally protected, please consider having : Durable Power of Attorney Property titled as Joint Tenants With Rights of Survivorship and Joint Bank accounts so your assets can pass directly to the beneficiaries after death avoiding probate Last Testament or Will Living Will Health Care Surrogate (in FL also called Health Care Proxy in other States) You can choose to have a Health Care or Medical Power of Attorney which combines the Living Will and Health Care Surrogate or Proxy) Pre-need Guardianship, in case a court determines you are unable to handle your medical and financial decisions HIPPA Release Form Some hospitals might request this in addition to a Health Care Surrogate Co-Parenting Agreement Anatomical Donation Form if you want to donate your body to an institution. Check with local medical schools. In Miami - http://biomed.miami.edu/ Ph. 305 243 06691 Important: Make sure all documents are compliant with your State For free forms, go to http://www.ilrg.com/forms/ For more info go to http://estate.findlaw.com/estate-planning/estate-planning-overview/ Even if you have a General Power of Attorney, most Financial Institutions will require that you and the patient sign their own custom forms. Check with them a.s.a.p. Consider a Trust and/or to have co-titled assets instead of including them in a Will If you dont have your legal affairs in order and/or are not married, please make sure you have at least a Health Care Surrogate form signed. You will need two witnesses and in some States, you might need to notarize it but for portability purposes you should always have it notarized and the Notary Public can be one of the witnesses. Always talk to your attorney and financial advisor about these documents Make sure at least two people (family or friends) know where you keep your legal documents and login information for ALL your internet accounts

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Estate Accounts
Estate accounts
An estate account is opened by the official representative of an estate (often called the administrator or executor), after a court (usually called probate court) appoints that representative. Accounts of the deceased individual are transferred to the estate account, and the estate account is used to pay expenses and collect money due to the estate (such as insurance proceeds, refunds, rebates, debts owed to the deceased, proceeds from the sale of estate property, etc.). The estate representative is responsible to the court for all the assets of the estate. He or she uses the funds in the estate account to pay taxes and other obligations of the estate (including final medical and funeral expenses, debts, etc.). Remaining funds are distributed to heirs, charities, trusts, etc., according to the decedent's will and/or state laws. (from http://www.bankingquestions.com)

Court ordered restricted estate accounts Normally used when minors are involved, and unfortunately, for most cases in Miami-Dade County All liquid assets need to go in and then distribute from the account by a court order. No money can come out until you get court approval. For people who have relatives in Cuba You need to talk with your lawyers in advance re. the naming of a court appointed guardian (there are only 5 attorneys in Miami authorized to represent Cuban citizens) and how the restricted Cuban accounts work Basically, there is no other option due to the US Cuban embargo. This Guardian will charge the Cuban citizen a $350 p/hour fee, present an invoice directly to the Court (you can ask for a copy) and will charge a percentage on the monies sent to Cuba. The inheritance could be reduced up to 50% of the original amount, mostly due to the Guardian keeping approximately 40% and the rest divided between Western Union and the Cuban Government foreign exchange fee. Make sure your lawyers explains to you this process and ask for other options. It might save you a lot of time and money to prepare a Will with all of this in mind.

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Your Testament or Will

When writing a Will, these are some tips to take into consideration: Try to convey your wishes as clearly as possible to your close family members and loved ones. Make sure they understand your wishes and reasoning behind your decisions and let them ask questions Consider the level of knowledge of the person you designate as the Estate Executor It takes a lot of work & time to talk to banks, pay expenses, etc. If the attorneys have to take care of all these issues, it will be extremely expensive Some knowledge of finance / accounting would be highly beneficial If you have assets in different states or other countries check with your Accountant, they are always a good source of information about this these issues Make sure you understand what are the restricted accounts in general and how they work (for Miami-Dade county) Make sure the bank you choose to open an account will be able to handle BOTH cash and investment accounts as restricted When defining other than family beneficiaries, make sure The non-profits or foundation have a clause where they cannot disagree if a settlement is needed Dont let them ask for more money to settle For your properties, cars, etc., you might consider the possibility of having everything co-title with the right of survivorship. Same with most bank accounts. These titles cannot be easily contested, the Will can! Make sure you dont name a beneficiary in your Will for a 401(k) account or any other savings / retirement account and have another beneficiary in the banks file. The Banks info will overwrite the Will. If you have been diagnose with a terminal illness and have debts, check with the institutions you owe money to. Some institutions might exonerate you if you get cancer or another debilitating illness that would not allow you to work
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A few words about the Health Care Documents

A durable power of attorney for health care (or Surrogate in FL) is a document in which one person (the principal) names another person (the agent, or the attorney-in-fact, or proxy) to make decisions about health care. A power is durable if it remains legally effective or becomes effective, when the principal becomes incapable of making health care decisions. A durable power of attorney for health care differs from a living will in that it focuses on the decision-making process and not on a specific decision. No living will can anticipate all possible circumstances. Thus, the power of attorney can cover a far broader range of health care decisions. The durable power of attorney for health care can include a living will provisiona description of health care preferencesor any other instructions but should, preferably, do so only as guidance for the agent, rather than as a binding selection. This is called health care advance directives in Florida. Most states require two witnesses, and a few permit notarization as an alternative. Most attorneys will recommend to do both A person who has capacity can cancel the durable power of attorney at any time. A durable power of attorney for health care is particularly important for all adults, even younger adults, who want someone other than next of kin to control decision making (for example, a partner, friend, or anyone else legally unrelated). For more info, go to http://www.merckmanuals.com/home/sec01/ch008/ch008e.html Special note for the LGBT Comm: LGBT couples should draw up advance directives in order to guarantee their rights, even if they are legally married. While, in some places, same-sex couples may obtain legal recognition of their relationships through marriage (such as in Connecticut, Iowa, Massachusetts, New Hampshire, New York, Vermont, and the District of Columbia) and broad domestic partnership and civil union laws (such as in New Jersey, Illinois, Delaware, Hawaii, California, Oregon, Washington State, and Nevada), most states still do not recognize these relationships, nor does the federal government. For more info, go to: FAMILY CAREGIVER ALLIANCE

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Surrogate decision making Order of Priority

If a person is unable to make decisions about personal health care, some other person or persons must provide direction in decision making. Such a person is called the surrogate decision-maker. If there is a durable power of attorney for health care, the agent appointed by that document is authorized to make health care decisions within the scope of authority granted by the document. If the person has a court-appointed guardian with authority to make health care decisions, the guardian is the authorized surrogate. If there is no appointed surrogate, the normal custom and practice, as well as the law in most states, permits health care practitioners to turn to next of kin as default surrogate decisionmakers. States that provide this option by statute typically provide an order of priority of surrogates starting with the person's spouse (or domestic partner in jurisdictions that recognize this status), then an adult child, a parent, a sibling, and then possibly other relatives. A growing number of states also authorize a close friend to act as default surrogate If more than one person has the same priority (such as several adult children), consensus is preferred, but some states allow health care practitioners to rely on a majority decision

Remember Doctors are more likely to accept the judgment of a person who understands the patient's medical situation and seems to have the best interest of the person in mind.
http://www.merckmanuals.com/home/sec01/ch009/ch009f.html

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HIPPA
Health care practitioners have a duty to keep personal medical information confidential. Communication between the patient and doctor is strictly confidential. Even well-meaning family members are not necessarily allowed to have information about a person's medical condition. All people are entitled to confidentiality unless they give permission for disclosure or they clearly can no longer express a preference (for example, if they are severely confused or comatose). A federal law called the Health Insurance Portability and Accountability Act, or HIPAA, applies to most health care practitioners and sets detailed rules regarding privacy, access, and disclosure of information. For example, HIPAA specifies the following:

People should normally be able to see and obtain copies of their medical records and request corrections if they find mistakes. Health care practitioners should routinely disclose their practices regarding privacy of personal medical information.

Health care practitioners may share the person's medical information, but only among themselves and only as much as is necessary to provide medical care. Personal medical information may not be disclosed for marketing purposes.
Health care practitioners should take reasonable precautions to ensure that their communications with the person are confidential. People may file complaints about privacy practices of health care practitioners.

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Do-not-resuscitate (DNR) order

A do-not-resuscitate (DNR) order placed in a person's medical record by a doctor informs the medical staff that cardiopulmonary resuscitation (CPR) should not be performed. This order is useful in preventing unnecessary and unwanted invasive treatment at the end of life.

A DNR order does not mean "do not treat." Rather, it means only that CPR will not be performed. Other treatments (for example, antibiotic therapy, transfusions, dialysis, or use of a ventilator) that may prolong life can still be provided. Treatment that keeps the person free of pain and comfortable (called palliative care) should always be given.

Most states also provide for special do-not-resuscitate orders that are effective outside of hospitals, wherever the person may be in the community. These are called out-of-hospital DNR orders and generally they require the signature of the physician and patient (or patient's surrogate).

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Financial Issues

Bank Documents
Most banks will NOT accept your Power of Attorney, but, with this document at hand, at least they will provide you with their custom forms. It will always be easier to have joints accounts or fill up the power of attorney form before you have an Make sure you also emergency, as have access to the usually, these forms safety deposit box require to be signed and/or other in front of a banks accounts official or to be (investment account, notarized savings, etc.)

If you decide to go for a Power of Attorney instead of joint accounts, most probably you will have to show them the original POA every time you visit the bank

and remember, a POA expires the minute a person dies

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Financial Issues
To have Internet access to your accounts, you will need
An User ID and an internet password to be able to access your accounts can be very useful in case of emergency The initial set up is very simple and can be done in a few minutes If you are planning to pay bills and/or make transfers to other banks, you most probably will be required to sign some specific forms (and maybe notarized them). This process takes some time and it would be difficult to accomplish if your partners is disabled. Also, once you have everything in place, you will be allowed only to make a couple of trial transfers for a minimum dollar amount. After a few days, you will be able to transfer full amounts, which normally take 3 to 5 days to show up in the new account Most banks do have some limits to the total amount you can transfer via the internet. Make sure you are aware of these limits

The Web
Your friend in times of trouble

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Disability Docs
What You Will Need to Apply On-Line The online Adult Disability and Work History Report will ask for information about you, your medical history, and your work and education history. The list below shows details about the information you will need: About You Your Social Security Number, name, address including ZIP code, telephone number, and e-mail address if you have one. The name, address including ZIP code, and telephone number of someone else who knows about your conditions. A description of your conditions, including when they began and how they keep you from working. Medical History The names, addresses including ZIP codes, and telephone numbers for all doctors, hospitals, and clinics that you have seen for these conditions and the dates you saw them. The name of each medical test that you have had, when and where the test was done, and who ordered it. The name of each prescription medicine that you take and the doctor who prescribed it. The name of each non-prescription medicine that you take. Work and Education History (if applicable) All the types of jobs you held in the last 15 years before you became unable to work because of your conditions. A description of the work you did. Information on your education and training. When your payments start Under the law, your payments cannot begin until you have been disabled for at least five full months. Payments usually start with your sixth month of disability. When Social Security tells you that you will be receiving disability benefit payments, the notice explains how much your disability benefit will be and when your payments start.

A word about Medicare

After you receive disability benefits for 24 months, you will be eligible for Medicare. You will get information about Medicare several months before your coverage starts. If you have permanent kidney failure requiring regular dialysis or a transplant or you have amyotrophic lateral sclerosis (Lou Gehrigs disease), you may qualify for Medicare almost immediately. Go to Social Security Adult Disability Web Site for more info.

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Disability
Some TIPS to process your Disability Claim - http://www.disabilitysecrets.com/tips.html
Take everything you are told about your Social Security Disability claim with at least one grain of salt.

Get copies of your medical records and supply these with your SSD or SSI disability application.
Respond to letters and notices regarding you disability case promptly--from social security, DDS, or your attorney.

The rule of three always applies--for those who are applying for benefits or appealing a denial.
If you are denied for Social Security Disability or SSI, you will need to file an appeal.

Call DDS for updates on your SSD or SSI claim, not the local Social Security office. The DDS Examiner, at Disability Determination Services, is the individual who actually works on your social security claim for disability benefits. In any state, the number for DDS can always be obtained from your local Social Security Office.
Representation will increase your chance of winning Social Security Disability or SSI benefits. If you have dire financial problems and have a Disability case, let people know.

If you have representation on a Social Security Disability or SSI disability case, keep your attorney or non attorney representative fully informed.
If you have child support obligations which you cannot fulfill, ask your attorney or representative to help.

Contact your congressman or senator to help you with your Social Security Disability or SSI claim.
If you have been approved for Social Security Disability or SSI, you will receive... Get your doctor to write a supporting statement for your Social Security Disability or ssi case. Make sure your doctor REALLY DOES support your SSD or SSI disability case.

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For more information, you can visit:

http://www.susannataddei.org/

http://www.lucreciadelrio.blogspot.com/
http://healthystate.org/videos

RELEASE AND WAIVER OF LIABLILITY: I hereby release the State of Florida, the Board of Governors, the University of South Florida, WUSF Public Broadcasting, and their officers, employees and agents (hereinafter collectively USF) from all actions, damages, or claims which I or my assigns may have against them which may be incurred as a result of the information presented in this Guide.

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