Planning for the Seriously Ill

by: Thomas D. Begley, Jr.

The American Bar Association has just published a booklet entitled “Legal Guide for the Seriously Ill:  Seven Key Steps to Get Your Affairs in Order.”  This article summarizes the ABA Report.

Step 1 – Plan How to Pay for the Health Care You Need

1.1 Worker’s Compensation

1.2 Social Security Disability Benefits

1.3 Veteran’s Benefits

1.4 Medicare

1.5 Medicaid

1.6 Private Medical Insurance

1.7 Accelerated Death Benefits under life insurance policies

1.8 Reverse Mortgage

1.9 Tax Deductions and Credits

1.10 Bankruptcy

Step 2 – Make a Plan to Manage to Health and Personal Decisions

2.1 Do a Living Will or Health Care Proxy and select a Health Care Agent or Health Care Representative

2.2 Include guidance in your Living Will for your Health Care Representative and communicate personally with that person to be sure they understand your wishes

2.3 Consider organ and tissue donations

2.4 Make burial and memorial plans

Step 3- Make a Plan to Manage Your Money and Property

Consider the following legal tools:

3.1 Joint ownership of bank accounts or other property with a “right of survivorship”

3.2 Power of attorney

3.3 Living trust

3.4 Appointment of Representative Payee for Social Security or other government benefits

3.5 Business Succession Plan

3.6 Determine eligibility for public benefits

3.7 Prepare a Will

3.8 Be sure beneficiaries of life insurance policies, retirement plans and annuities are correct

3.9 Consider an Ethical Will

Step 4 – Plan for Care of Dependents

Arrange for the care of your children and pets:

4.1 Arrange for custody/guardianship of minors or other dependents

4.2 Establish special needs trust for disabled persons

4.3 Consider trusts to protect beneficiaries from themselves, their creditors and ex-spouses

4.4 Plan for your pets

Step 5 – Know Your Rights as a Patient

Core rights for those with serious conditions include:

5.1 Good pain and symptom management

5.2 High quality of care

5.3 Consent to participation in any experimental treatments

5.4 Access to and privacy of your medical records

5.5 Visitation in hospital and nursing home settings

Step 6 – Know Your Rights and an Employee

Potential employee rights include the following:

6.1 Leave instructions for medical treatment or care, including possible rights under the Family and Medical Leave Act and Americans with Disabilities Act Leave

6.2 Know your rights regarding health care and pension plans, including ERISA, ADA protections and COBRA

Step 7 – Get Your Legal Documents in Order

Certain steps are necessary to avoid confusion and delay:

7.1 Collect all of your important legal documents, including adoption papers, birth certificate, citizenship papers, death certificate of spouse, designation of guardian, divorce papers, DNR orders, health care advance directives, marriage certificates, powers of attorney, prenuptial agreements, trust documents, VA discharge documents and Wills

7.2 Store your legal documents in a safe and accessible location

7.3 Let people know where your important documents are kept