Alleviating Workplace Woes for Cancer Patients

We often encounter clients who are struggling with work issues during cancer treatment. Consider the mother who must hold on to her job in order to keep health insurance for herself and her family. Many people have no idea what they are required to tell their employer or what they should share with coworkers. Clients also need answers about how they can use Family and Medical Leave Act (FMLA) benefits.

Likewise, local employers need dependable information about how to best support employees who have cancer without jeopardizing the success of their business.

Fortunately, the client advocates at Cancer Services of Northeast Indiana have specialized training in this area and readily offer their knowledge and guidance to both employees and employers before, during and after treatment.

If you are an employee, advocates can help:

  • Explain FMLA and other benefits. Employees may be unsure of the best way to share their diagnosis at the workplace, or even if they must disclose it to their employer. They may need direction on how and when to apply for FMLA, Short or Long-term Disability, or Social Security Disability benefits. We can provide that direction as well as help people understand the differences between these programs.
  • Facilitate open communication with an employer. Conversations with an employer can lead to better results for the employee such as a reduced work schedule during treatment weeks. Employees may also benefit from a flex-schedule or telecommuting to better accommodate work demands and treatment schedules.
  • Provide reasonable solutions. A quieter environment might help an employee who is struggling with chemo-fog. Employees undergoing or recovering from treatment may also need an increased number of bathroom breaks, or more opportunities to sit because of neuropathy in their feet.

If you are an employer, client advocates can help:

  • Balance the needs of the employee with the needs of the business. We can help employers who are seeking the best way to balance the legal rights of their employees with the needs of the business. Human Resource managers might be unsure of how to navigate the concern of other employees who might perceive an employee with cancer as receiving “favoritism.” They also may be worried about the cost of providing an employee with “reasonable accommodations.”
  • Prepare a strategy. Cancer Services can help businesses that currently do not have any employees with cancer, but would like a plan in place should the need present itself. Advocates can assist in providing education and support, developing a plan for working during treatment, and providing outside resources and referrals to both employees and employers to navigate through all of these concerns.

We know that employment and careers are vital aspects of the quality of life and we are here to help. For more information, visit www.cancer-services.org or give us a call at 260-484-9560.

Liz Karst - cropped
Liz Karst
Written by: Liz Karst, Client Advocate for Cancer Services of Northeast Indiana
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INvestABLE

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Last year, we highlighted a new provision offered to families with disabled children called ABLE accounts. ABLE accounts (which stands for Achieving a Better Life Experience) are intended to create tax-free savings accounts for individuals with disabilities. The goal of these accounts is to ease the financial strains faced by individuals with disabilities and their families. These accounts supplement, rather than replace, the benefits someone may already be receiving, such as through private insurance, Medicaid, or other sources.

Now, Indiana has received the state funding to implement and create this program under the name INvestABLE. The new INvestABLE program helps disabled individuals to save money while preserving their government-assisted benefits like SSI and Medicaid. The earnings on your investments are federally tax-deferred and tax-free if used for qualified disability expenses. Qualified disability expenses include any expense incurred as a result of living with a disability and that is intended to improve your quality of life. This would include things such as education, health and wellness, housing, transportation, legal fees, financial management, employment training and support, adaptive technology, personal support services, oversight and monitoring, and funeral and burial expenses.

Previously, individuals were required to keep their resources under $2,000 to qualify for SSI and Medicaid. With the ABLE accounts, an individual can save up to $14,000 per year and up to $100,000 total in the account. Balances of $100,000 or less are excluded from your SSI resource limit. Only the amount over $100,000 is counted against your limit.

You can open an ABLE account quickly and easily here. Just tell them a little bit about yourself and select your investments. That’s it. You can easily access your account at any time, from a PC, tablet, or mobile device. Plus, you can get started with as little as $25.

In celebration of this new program, the Indiana Treasurer of State and the Indiana ABLE Authority will be hosting a launch event in Fort Wayne at the Turnstone Center on August 30.

New Change for Special Needs Trusts

special-needs-trusts

On December 13, 2016, the President signed into law the 21st Century Cures Act. Section 5007 of this Act affects the Special (or Supplemental) Needs Trusts, dealing specifically with the d(4)(A) Special Needs Trusts. A d(4)(A) Special Needs Trust is a trust created for the sole benefit of someone under the age of 65 who is disabled. The d(4)(A) Special Needs Trust is established by the beneficiary’s parent, grandparent, legal guardian, or the court, and it is funded with the beneficiary’s own assets.  This type of trust must include repayment language, which states that any remaining assets at the beneficiary’s death must go to any state Medicaid agency (up to the amount paid by the state for the beneficiary under the Medicaid program).

For d(4)(A) Special Needs Trusts created before December 31, 2016, the trust has to meet the following requirements to be valid:

  • The trust contains the assets of an individual who is under 65 and disabled.
  • The trust is established for the benefit of the individual through the actions of a parent, grandparent, legal guardian, or a court.
  • The State will receive the remaining amount in the trust after the individual dies up to an amount equal to the total Medicaid assistance paid on their behalf.

With the new Act signed into Law, an additional provision has been added to the requirements for d(4)(A) Special Needs Trusts (dated after December 31, 2016). Now, the trust can be established for the benefit of the individual through the actions of the individual, parent, grandparent, legal guardian, or a court. All other requirements still apply. This is good news for those who may utilize this type of trust for their disabled loved ones! Our firm specializes in Trusts and Estates. We would be happy to help you create this trust for yourself or a loved one who is under 65 and disabled.

How to Dispose of Unwanted Medication

medicine

Previously, many people thought that flushing unwanted medication down the toilet was a safe and easy solution. Now, flushing unwanted medication down the toilet is considered the least desirable of all alternatives. Recent U.S. geological studies have found traces of estrogen, painkillers, antidepressants, blood pressure medicine, etc. in water samples from 30 states. Studies have linked the hormone exposure to reproductive defects in fish. Also, they have linked the environmental exposure to antibiotics to the development of drug-resistant germs.

Help to protect our rivers and waterways by disposing of unwanted medication in the proper locations. The Allen County TRIAD sponsors a year-round medication collection program with the support of local police and sheriff’s departments. In Allen County, the collection boxes are available at the following police and sheriff posts:

Northwest

Huntertown Town Hall
15617 Lima Road

Phone: 260-637-5058
Hours: Mon-Fri; 8:00-5:00

Southwest

Indiana State Police Post
5811 Ellison Road

Phone: 260-432-8661
Hours: 24/7 in lobby

Source: http://www.acwastewatcher.org/household-hazardous-waste/unwanted-medication-disposal/

Signs of Elder Abuse

Elder abuse

One million Americans age 65+ report having been abused by a loved one or someone they depend on for care. Only 1 in 14 incidents of elder abuse are ever reported to authorities. And only 1 in 25 cases of financial exploitation are ever reported, meaning there may be at least 5 million financial abuse victims each year. Elder abuse is becoming more and more common. As seniors age and become more physically frail, they are unable to stand up to bullying or fight back. Also, because they may not see or hear as well or think as clearly, this leaves openings for unscrupulous people to take advantage of these seniors. There are several risk factors that can increase the likelihood of elder abuse. Elder abuse can come in many forms:

  • Physical abuse
    • What? Use of force against an elderly person that results in pan, injury, or impairment
    • Signs: Unexplained signs of injury; broken bones; signs of being restrained; caregiver’s refusal to allow you to see the elder alone
  • Emotional abuse
    • What? Speak to or treat elderly persons in ways that cause emotional pain or distress
    • Signs: Caregiver threatens, belittles, or controls the elder; elder rocks, sucks, or mumbles to him/herself
  • Sexual abuse
    • What? Contact with an elderly person without his/her consent
    • Signs: Bruising around breasts or genitals; genital infections; vaginal or anal bleeding; torn, strained, or bloody underclothing
  • Neglect or abandonment
    • What? Failure to fulfill a caretaking obligation
    • Signs: Unusual weight loss, dehydration, or malnutrition; untreated physical problems; unsanitary living conditions; being left dirty or unbathed; unsafe living conditions; desertion of elder at public place
  • Financial exploitation
    • What? Unauthorized use of an elderly person’s funds or property
    • Signs: Significant withdrawals from his/her accounts; items or cash missing from elder’s home; suspicious changes in estate planning and financial documents; unnecessary services, goods, or subscriptions
  • Healthcare fraud
    • What? Committing fraud by unethical doctors, nurses, or other healthcare providers
    • Signs: Duplicate billings for same service; evidence of overmedication or undermedication; evidence of inadequate care even when bills paid in full

If you suspect elder abuse, then you must take preventative measures. Learn more in our next post.

Risk Factors of Elder Abuse

elder abuse risk factors

It is difficult to take care of an elderly person with many different needs and infirmities. Both the demands of caregiving and the needs of an elderly person can create situations where abuse is more likely to occur. For a caregiver, the responsibilities and demands can be extremely stressful. This stress can cause a caregiver to burn out, become impatient, or lash out at the elderly person. Some risk factors for caregivers include:

  • inability to cope with stress
  • depression
  • lack of support from other caregivers
  • substance abuse
  • inability to see psychological rewards

These risk factors can lead to high stress levels and cause the caregiver to abuse his/her patients. Nursing home staff may be prone to elder abuse if they lack training, are unsuited to caregiving, have too many demands, or work under poor conditions.

While elder abuse is never excusable, there are some factors that can make an elder at greater risk for elder abuse. Some of these factors include:

  • grave illness
  • serious dementia
  • social isolation
  • history of domestic violence
  • history of elder acting as an abusive relative
  • a senior’s tendency toward aggression

Because of these risk factors (for caregivers and for elders), elder abuse may happen, though unintentionally. The caregiver may be pushed beyond his/her capabilities, causing him/her to strike out or ignore the needs of his/her patient. Knowing the risk factors can help prevent elder abuse. However, there are also warning signs to look out for in case elder abuse happens. Learn the warning signs in our next post.

2016 Hot Topics for Indiana Lawyers

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This year is the fifth annual Hot Topics for Indiana Lawyers. The event will be held on September 22 and 23 from 8:30 a.m. to 4:00 p.m. at the Grand Wayne Center, 120 W. Jefferson Blvd. The event will count for 12 CLE credits, which includes 1.5 ethics credits.

Our attorneys, Tracy Troyer and Leah Good, will be speaking at the event on Thursday, September 22. The title of their presentation is “Estate Planners: Medicaid Law.” They will speak with the assembly about the 2016 Indiana law changes regarding Medicaid.

For more information on attending, please check out the Allen County Bar Association website.

Senior Savings Protection Act

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There is a new law called “The Senior Savings Protection Act.”  On July 1st, Indiana enacted this law which creates new rules and responsibilities for individuals associated with a broker-dealer in a supervisory, compliance, or legal capacity.  The Act requires those individuals to take action in certain situations when working with a client who is a financially endangered adult.

A financially endangered adult is defined as someone who is age 65 or older or a younger person who is not able to manage his/her property because he/she is mentally ill, intellectually disabled, or suffering from some other type of incapacity, such as dementia.  The triggering events requiring the individual to take action are when he/she has reason to believe financial exploitation of the financially endangered adult has occurred, has been attempted in the past, or is currently being attempted.

If there is financial exploitation, then the individual is required to make a report to Adult Protective Services or to a law enforcement agency and also notify the securities commissioner.  After these mandatory notifications are made, the individual may also choose to notify the adult’s immediate family members, legal guardian, trustee, attorney-in-fact, or others who have been previously agreed to in a customer agreement.

Furthermore, the individual can refuse to make disbursements from the adult’s account or from an account of which the adult is a beneficiary if he/she has reason to believe the disbursements will result in financial exploitation.  If a disbursement is refused, the individual must notify all parties authorized to transact business on the account as well as Adult Protective Services.  However, if the individual believes a party authorized to transact business on the account is involved in the exploitation, that person is not entitled to notification.

An individual is immune from civil liability when acting in good faith under this new law.  The commissioner will be making training resources available on these issues on the Secretary of State’s website by September of next year.

Paying for Nursing Home Care

nursing home

Medicare. Medicare can pay some nursing facility expenses if you are eligible and several requirements are met. You must go to the nursing home soon after a hospital stay of at least 3 days. The home (including the wing or part where you live) must be certified as a Medicare skilled nursing facility, and you must need that level of care. Medicare can pay basic expenses for the first 20 days in the nursing home. From day 21 through day 100, Medicare can pay for expenses after you pay a set amount each day (the amount changes every year). Medicare seldom pays any expenses after 100 days in the nursing home.

Medicaid. Medicaid can help pay for nursing facility services if you meet the categorical and financial eligibility requirements. If you are not within the income limits, you might be eligible for Medicaid anyway if your medical expenses are high enough. The Medicaid laws help protect the income and resources of the “at home” spouse of the nursing home resident. Even if you are not eligible for Medicaid when you enter the nursing home, you may find that your personal resources run out soon, and you need Medicaid. This happens to many people so you may want to consider choosing a nursing home that is certified by Medicaid, in case you later need that program’s help.  Our attorneys can assist getting you or your loved one eligible for Medicaid if it looks like nursing home care is imminent.

Veterans’ Benefits. Some veterans can get help with nursing home expenses from the Veterans Administration. Some children and surviving spouses of veterans can also get this help. To receive these benefits, you must choose a nursing home that is under contract with the Veterans Administration.

Private Health Insurance. Private insurance might pay some nursing home expenses. Because Medicare pays so little, you should consider buying private insurance that covers long term nursing care. Shop carefully. Some Medicare Supplement policies cover nursing home expenses only after Medicare benefits are exhausted. Yet Medicare law makes it difficult to “use up” your Medicare coverage. As a result, you may be left with a useless insurance policy that never takes effect.

Source: Indiana Laws of Aging by Indiana State Bar Association

General Tips on Shopping for Health Insurance

health insurance

Whatever type of health insurance you want, you should shop carefully and compare the policies of different companies using a reputable health insurance agent to guide you through the process. This post has some general tips when shopping for health insurance:

  1. Consider how quickly the insurance company pays a claim and whether the company gives you individual attention and helps you answer questions about your policy.
  2. If you are older, it may be better to keep the insurance you already have in force. This is not always the case so consider the matter carefully.
  3. Check the waiting period to see how soon the policy will cover an illness that began after the effective date of the policy. If you have an existing condition that will later require medical attention, you want insurance that will cover those expenses as soon as possible.
  4. Watch out for policies that pay fixed amounts for certain expenses. They may seem cheap but rapidly become inadequate as medical expenses increase.
  5. Be suspicious of policies that let the insurance company refuse to renew your policy on an individual basis.
  6. Neither the state nor federal government sells a policy to supplement Medicare. Therefore, beware of someone who offers you insurance sponsored by the government.
  7. Purchasing more than one Medicare Supplement policy is usually a poor buy.
  8. Indiana law protects you against aggressive sales tactics. Even if you have already signed an application, you may cancel a health insurance policy within ten days of receiving the policy. Simply mail the policy back to the insurance company’s home office and ask for a refund of any premium you paid.
  9. You should pay premiums by check, not cash. Make the check payable to the insurance company, not the agent.
  10. Keep a copy of your completed application so that you know what you have purchased. Get a receipt for anything you give to the insurance agent. The receipt should have the agent’s name, company address, and company telephone number.
Source: Indiana Laws of Aging by Indiana State Bar Association