Upon my return from the National Hip Replacement Summit in Chicago, IL, I believe it is important to get the word out about how dangerous this defective DePuy hip replacement surgery has been. A massive tort action will be needed if you or a loved one, or anybody you know has been a recipient of a DePuy ASR device as part of a hip replacement surgery since 2003. You should contact me immediately for legal advice.
What has came to light last August is that DePuy Orthopaedics, a subsidiary of Johnson and Johnson Corp. betrayed 93,000 persons between 30 – 55 years old and older, with the promise of a new and active life, pain free with full modality of their hip, when in reality DePuy had full knowledge these “ASR devices” were defectively designed. Statistics showed that 1 out of 8 persons would need a replacement hip within five years (many within the first year) resulting in extreme pain, lengthy rehab, and a crippled hip life.
Once again, the corporate bottom line trumped the risk of disabling the consumer. By 2009, DePuy announced a profit of 5.4 BILLION dollars, and yet they continued to sell the known defective ASR devices until they “volunteered” to recall them August 24, 2010.
What is more disgusting than DePuy’s betrayal to the consumer and surgeons is the actual fact of the damage caused by these devises and the lethal harm to patients if not detected as soon as possible.
The true danger lies in the asymptomatic joint region where because the ASR titanium ball or cup chafes off its titanium flakes into the blood stream. The body’s immune system attacks the joint with extremely high levels of chromium and cobalt. These high levels of ions enter the joint and chemically produce a poison called ALVAL that kills the flesh, ligaments, bones and other tissue that cannot be rejuvenated. This metalloid reaction causes the bone to loosen through osteolysis where the immune system attempts to reabsorb the bone by cracking and wearing it down so that it can no longer hold the ASR ball at the top of your femur. The ball dislocates from the hip and causes exactly what you do not want to happen to anyone because it cannot be repaired without permanent damage.
I realize the above sounds pretty technical, but one look at the films would explain it all. It is all very ugly and you would not wish it on your worst enemy. When you add the fact it could have been avoided by a moral manufacturer, it makes you sick.
Mark S. Cornwall lives in Santa Barbara, CA. and can be reached at www.markcornwall.com, or at (805) 845-7558.
Wednesday, October 27, 2010
Thursday, October 21, 2010
Recall of DePuy Hip Replacement Device: Know Your Rights
This alert is to help those people who have been victimized, or will be victimized, by a failed hip surgery replacement implant from 2003 to the present. By letter dated Aug. 24, 2010, DePuy Orthopeadics, a subsidiary of Johnson & Johnson, recalled 93,000 defective implants on a so-called voluntary basis.
The two hip replacement devices recalled are known as the ASR Hip Recurring System and the ASR XL Acetabluor System, commonly referred to as ASR. According to a source familiar with the protocol of Santa Barbara Cottage Hospital, if you had a hip replacement surgery at Cottage Hospital any time in the past seven years, you have probably had it replaced with one or both of these DePuy devices because of the hospital’s preference among competing brands. That leaves about 1,300 potential patients at risk during the past five years.
If you haven’t already done so, you need to talk to your treating physician about how the recall of the ASR and the possibilities of its failure to work within the first five years will affect you. It could require a replacement surgery with the attenuating rehabilitation. The device is supposed to last for at least 15 years. Johnson & Johnson recalled this replacement hip system because the devices have a 12 percent to 13 percent chance of coming loose, fracturing the bone around the implant, releasing titanium metal flakes into your blood stream and causing tumors, as well as greatly increasing the possibility of infection.
WHAT TO DO
A 12 percent failure rate is astronomic in the world of implant recalls. Meanwhile, DePuy has begun a very aggressive campaign to find the recipients of the defective devices and attempt to settle any potential case the victims may have for the cost of replacement surgery. You will receive a letter from DePuy — actually, from its insurance company named Broadspire, which will attempt to have you sign a document for your authorization to receive all your medical records from anywhere, to be shared with any “service provider” contracted by DePuy. Do not sign this authorization for medical records.
The authorization will be abused and all your medical records will be shared with claims adjustors, attorneys and computer statistics, and against you in order to settle for the least amount of money possible. It will not cover the pain and suffering, e.g. the disappointment of a failed surgery, months of rehabilitation, the need for a replacement surgery, time, expense, lost wages and, in many cases, years of never-ending hip pain requiring cortisone shots every three months.
Because of the ASR never working for many patients, it has made life more miserable both after the implant surgery and before the replacement surgery by knowing you may have your hip replaced again, and start the rehab process from the beginning again. It is always more difficult to mend the second time, but the relief is worth it.
The next step is to obtain your medical records from your treating orthopedist and bring them to an ASR recall lawsuit counselor such as myself. Your case can then be confidentially analyzed and a well-planned strategy can be pursued on your behalf alone. It is not advisable to be part of a class-action lawsuit unless you have little or no injuries or cost of damages. The attorneys are the only ones who come out ahead on class actions. If your case is more serious than that, you need private legal counsel familiar with the implant recall and its fiscal ramification that will handle your case on a contingency fee basis.
What DePuy Isn’t Telling You
According to the letter you will receive from DePuy, or on its Web site, the “voluntary recall” of the ASR products came about as follows:
“Johnson & Johnson announced the recall of the DePuy ASR Hip Implant system after data from the National Joint Registry of England and Wales showed that 1 out of every 8 patients (12 percent to 13 percent) who had received the recalled devices had to undergo revision surgery within five years of receiving it. It is suppose to work for 15 years. The recall involved the ASR XL Acetabular System, a hip socket used in traditional hip replacement, and the ASR Hip Resurfacing System, a partial hip replacement that involves placing a metal cap on the ball of the femur. Only the ASR XL Acetabular System was approved for use in the U.S.
“The truth is that according to the Australian Joint Registry — the second-largest database in the world after the England and Wales National Joint Registry — issued seven reports to DePuy starting in 2007 that identified problems with the hip implant system. The ASR system was finally withdrawn from the Australian market in December 2009.”
DePuy has long known the problems caused by its ill-designed hip replacement device, yet it continued to sell it to Americans for nearly a year after being ousted from Australia. That means DePuy made billions of dollars off the risk of your suffering.
I will be attending the National Hip Replacement Summit in Chicago Oct. 21-23. I can be reached at mscornwall@aol.com or (805) 845-7558.
The two hip replacement devices recalled are known as the ASR Hip Recurring System and the ASR XL Acetabluor System, commonly referred to as ASR. According to a source familiar with the protocol of Santa Barbara Cottage Hospital, if you had a hip replacement surgery at Cottage Hospital any time in the past seven years, you have probably had it replaced with one or both of these DePuy devices because of the hospital’s preference among competing brands. That leaves about 1,300 potential patients at risk during the past five years.
If you haven’t already done so, you need to talk to your treating physician about how the recall of the ASR and the possibilities of its failure to work within the first five years will affect you. It could require a replacement surgery with the attenuating rehabilitation. The device is supposed to last for at least 15 years. Johnson & Johnson recalled this replacement hip system because the devices have a 12 percent to 13 percent chance of coming loose, fracturing the bone around the implant, releasing titanium metal flakes into your blood stream and causing tumors, as well as greatly increasing the possibility of infection.
WHAT TO DO
A 12 percent failure rate is astronomic in the world of implant recalls. Meanwhile, DePuy has begun a very aggressive campaign to find the recipients of the defective devices and attempt to settle any potential case the victims may have for the cost of replacement surgery. You will receive a letter from DePuy — actually, from its insurance company named Broadspire, which will attempt to have you sign a document for your authorization to receive all your medical records from anywhere, to be shared with any “service provider” contracted by DePuy. Do not sign this authorization for medical records.
The authorization will be abused and all your medical records will be shared with claims adjustors, attorneys and computer statistics, and against you in order to settle for the least amount of money possible. It will not cover the pain and suffering, e.g. the disappointment of a failed surgery, months of rehabilitation, the need for a replacement surgery, time, expense, lost wages and, in many cases, years of never-ending hip pain requiring cortisone shots every three months.
Because of the ASR never working for many patients, it has made life more miserable both after the implant surgery and before the replacement surgery by knowing you may have your hip replaced again, and start the rehab process from the beginning again. It is always more difficult to mend the second time, but the relief is worth it.
The next step is to obtain your medical records from your treating orthopedist and bring them to an ASR recall lawsuit counselor such as myself. Your case can then be confidentially analyzed and a well-planned strategy can be pursued on your behalf alone. It is not advisable to be part of a class-action lawsuit unless you have little or no injuries or cost of damages. The attorneys are the only ones who come out ahead on class actions. If your case is more serious than that, you need private legal counsel familiar with the implant recall and its fiscal ramification that will handle your case on a contingency fee basis.
What DePuy Isn’t Telling You
According to the letter you will receive from DePuy, or on its Web site, the “voluntary recall” of the ASR products came about as follows:
“Johnson & Johnson announced the recall of the DePuy ASR Hip Implant system after data from the National Joint Registry of England and Wales showed that 1 out of every 8 patients (12 percent to 13 percent) who had received the recalled devices had to undergo revision surgery within five years of receiving it. It is suppose to work for 15 years. The recall involved the ASR XL Acetabular System, a hip socket used in traditional hip replacement, and the ASR Hip Resurfacing System, a partial hip replacement that involves placing a metal cap on the ball of the femur. Only the ASR XL Acetabular System was approved for use in the U.S.
“The truth is that according to the Australian Joint Registry — the second-largest database in the world after the England and Wales National Joint Registry — issued seven reports to DePuy starting in 2007 that identified problems with the hip implant system. The ASR system was finally withdrawn from the Australian market in December 2009.”
DePuy has long known the problems caused by its ill-designed hip replacement device, yet it continued to sell it to Americans for nearly a year after being ousted from Australia. That means DePuy made billions of dollars off the risk of your suffering.
I will be attending the National Hip Replacement Summit in Chicago Oct. 21-23. I can be reached at mscornwall@aol.com or (805) 845-7558.
Tuesday, October 12, 2010
THE DePUY ASR HIP REPLACEMENT DEVICE: YOUR RIGHTS
THE DePUY ASR HIP REPLACEMENT DEVICE RECALLED:
YOUR RIGHTS
Mark S. Cornwall, is resuming his 25 years of litigation practice in the field of personal injury solely to help those persons who have been victimized by failed hip surgery replacement devices. In August 2010, the DePuy (pronounced like Pepe “Lepeu”) Orthopedics, a subsidiary of Johnson and Johnson, recalled 93,000 defective implants, on a so called voluntary basis.
The two hip replacement devices recalled are known as the ASR Hip Recurring System and the ASR XL Acetabluor System, commonly referred to as ASR.
If you have had your hip replaced due to the ASR failing and/or have had it replaced with another device due to the failure of the ASR between 2003 to the present, please, call the Law Office of Mark S. Cornwall to understand your legal rights on pursuing your claim. Talk to your treating physician about how the recall of the ASR and the possibilities of its flaking off titanium chips into your blood stream can affect you.
Johnson and Johnson recalled this replacement hip because the devices have a 12% chance of coming loose, fracturing the bone around the implant and causing tumors, as well as metal particles into your blood stream.
A 12% failure rate is astronomic in the world of recalls. A 5% failure rate would be more than sufficient. Johnson and Johnson has admitted it is to blame, but this knowledge of failure has been known for years before now, and they DePuy has kept selling them at the expense of their patients pain, e.g. the disappointment of its failed surgery, months of rehabilitation, the need for a replacement surgery, time, expense, lost wages, and in many cases years of never ending hip pain, requiring cortisone shots, every three months that did not work. Because of the ASR never working for many patients it has made life more miserable both before and after the replacement surgery knowing you would have to have your hip replaced again, and start the rehab process from the beginning again. It is always more difficult to mend the second time, but the relief is worth it.
The Law Office of Mark S. Cornwall has a history of winning lawsuits against the biggest manufacturing and retail corporations in American: Harley Davidson, Big Five Sporting Goods, both United and KLM Airlines, and McDonalds to name a few. But they all have insurance companies and without exception they do not want to pay you a dime.
DePuy has sold more than 93,000 of these and similar products worldwide, with sales totaling more than $5.4 billion in 2009. In December of that year they stopped selling the implants in the Nation of Australia due to complaints from hip plant receivers where hip replacement is common since the average person in Australia walks the most steps per day in the world. America is last on that list. In March of 2010, the company wrote letters to all orthopedists warning doctors of the possibility of early failure of their products.
Then on August 26, 2010, they sent orthopedists an “Alert Letter” warning doctors that use of the implant could result in failure due to problems in the device itself. That is almost an admission, but it is not what they are blaming this voluntary recall on. They are blaming it on 1) the way the doctors placed the system during surgery, and 2) they claim they were taking it off the market anyway because its sales were not making money for DePuy aka Johnson & Johnson.
“Johnson & Johnson announced the recall of the DePuy ASR Hip Implant system after data from the National Joint Registry of England and Wales showed that 1 out of every 8 patients (12%-13%) who had received the recalled devices had to undergo revision surgery within five years of receiving it. It is suppose tp work for 15 years. The recall involved the ASR XL Acetabular System, a hip socket used in traditional hip replacement, and the ASR Hip Resurfacing System, a partial hip replacement that involves placing a metal cap on the ball of the femur. Only the ASR XL Acetabular System was approved for use in the US.
According to a report on the Independent, a UK media outlet, the Australian Joint Registry – the second largest database in the world after the England and Wales National Joint Registry – issued seven reports to DePuy starting in 2007 that identified problems with the hip implant system. The ASR system was finally withdrawn from the Australian market in December 2009.
Professor Stephen Graves, director of the Australian National Joint Replacement Registry, told the Independent that DePuy had behaved “irresponsibly and very badly,” putting patients needlessly at risk. “It is a complete untruth that DePuy did not have reason to withdraw the ASR before now; we have been telling them since 2007, but they allowed it to be used on thousands of people,” Graves said,” according to the Registry.
Mark S. Cornwall 1 (805)845-7558
YOUR RIGHTS
Mark S. Cornwall, is resuming his 25 years of litigation practice in the field of personal injury solely to help those persons who have been victimized by failed hip surgery replacement devices. In August 2010, the DePuy (pronounced like Pepe “Lepeu”) Orthopedics, a subsidiary of Johnson and Johnson, recalled 93,000 defective implants, on a so called voluntary basis.
The two hip replacement devices recalled are known as the ASR Hip Recurring System and the ASR XL Acetabluor System, commonly referred to as ASR.
If you have had your hip replaced due to the ASR failing and/or have had it replaced with another device due to the failure of the ASR between 2003 to the present, please, call the Law Office of Mark S. Cornwall to understand your legal rights on pursuing your claim. Talk to your treating physician about how the recall of the ASR and the possibilities of its flaking off titanium chips into your blood stream can affect you.
Johnson and Johnson recalled this replacement hip because the devices have a 12% chance of coming loose, fracturing the bone around the implant and causing tumors, as well as metal particles into your blood stream.
A 12% failure rate is astronomic in the world of recalls. A 5% failure rate would be more than sufficient. Johnson and Johnson has admitted it is to blame, but this knowledge of failure has been known for years before now, and they DePuy has kept selling them at the expense of their patients pain, e.g. the disappointment of its failed surgery, months of rehabilitation, the need for a replacement surgery, time, expense, lost wages, and in many cases years of never ending hip pain, requiring cortisone shots, every three months that did not work. Because of the ASR never working for many patients it has made life more miserable both before and after the replacement surgery knowing you would have to have your hip replaced again, and start the rehab process from the beginning again. It is always more difficult to mend the second time, but the relief is worth it.
The Law Office of Mark S. Cornwall has a history of winning lawsuits against the biggest manufacturing and retail corporations in American: Harley Davidson, Big Five Sporting Goods, both United and KLM Airlines, and McDonalds to name a few. But they all have insurance companies and without exception they do not want to pay you a dime.
DePuy has sold more than 93,000 of these and similar products worldwide, with sales totaling more than $5.4 billion in 2009. In December of that year they stopped selling the implants in the Nation of Australia due to complaints from hip plant receivers where hip replacement is common since the average person in Australia walks the most steps per day in the world. America is last on that list. In March of 2010, the company wrote letters to all orthopedists warning doctors of the possibility of early failure of their products.
Then on August 26, 2010, they sent orthopedists an “Alert Letter” warning doctors that use of the implant could result in failure due to problems in the device itself. That is almost an admission, but it is not what they are blaming this voluntary recall on. They are blaming it on 1) the way the doctors placed the system during surgery, and 2) they claim they were taking it off the market anyway because its sales were not making money for DePuy aka Johnson & Johnson.
“Johnson & Johnson announced the recall of the DePuy ASR Hip Implant system after data from the National Joint Registry of England and Wales showed that 1 out of every 8 patients (12%-13%) who had received the recalled devices had to undergo revision surgery within five years of receiving it. It is suppose tp work for 15 years. The recall involved the ASR XL Acetabular System, a hip socket used in traditional hip replacement, and the ASR Hip Resurfacing System, a partial hip replacement that involves placing a metal cap on the ball of the femur. Only the ASR XL Acetabular System was approved for use in the US.
According to a report on the Independent, a UK media outlet, the Australian Joint Registry – the second largest database in the world after the England and Wales National Joint Registry – issued seven reports to DePuy starting in 2007 that identified problems with the hip implant system. The ASR system was finally withdrawn from the Australian market in December 2009.
Professor Stephen Graves, director of the Australian National Joint Replacement Registry, told the Independent that DePuy had behaved “irresponsibly and very badly,” putting patients needlessly at risk. “It is a complete untruth that DePuy did not have reason to withdraw the ASR before now; we have been telling them since 2007, but they allowed it to be used on thousands of people,” Graves said,” according to the Registry.
Mark S. Cornwall 1 (805)845-7558
Monday, August 9, 2010
DON’T LET YOUR ELDERS GET FLEECED!
It is not found in just this column, or the Washington Post and New York Times, but also in the Los Angeles Times. The top, number one subject in estate planning today is to disperse as much information necessary to alert all baby boomers and senior citizens of their vulnerability to financial fraud. Elder abuse from financial fraud is running amuck, and is difficult to detect if you are unaware of the signs.
The problem, or at least the biggest problem, is that the persons perpetrating the fraud are those that most people believe would be the last person to do it. It is that long, or so you thought, trusted friend that always came two or three times a week for tea. Or that sweet niece that always came over and washed that old neighbor’s towels, or his daughter who came from Arizona just to help him out.
Worse, it could be that care-giver paid by Medi-Cal who is suppose to do a job, only to show up with larceny in their heart once they understand how alone and alienated some older individuals can be made from the rest of society.
According to the Los Angeles Times, crediting a newly released survey, one senior in five has been taken in some form of financial con. It is exactly that one in five (20 percent chance) whom the con men and women are looking for to take advantage. If you say, “I’m looking for a ‘reverse mortgage’ on my house,” and they answer, “I have something better for you than a reverse mortgage!” -- followed by a pitch that is an incomprehensible financial alternative and all you understand is the bottom line, which of course sounds too good to be true and you believe it, then you are in trouble. The elder citizen that enjoyed talking with the polite man’s voice might think it must be their lucky day, when in fact it is the other way around.
Even people in their fifties do not realize how much money a seventy year old senior has stashed away as a result of frugal living and conservative investments. Not everyone is a crook, but the crooks are looking for these small fortunes saved by a man who sometimes has a day of dementia, or the elderly woman who was not thinking clearly only because she had started a new medication routine.
All this led to some security regulators working for the Texas Securities Commissioner to discover that a disproportionate number of elderly fraud victims were suffering from some level of dementia. This led them to wonder if there were any red flags that may be seen on these vulnerable elders that could be identified before they got fleeced.
They joined forces with Dr. Robert Roush of Baylor College of Medicine and formed a coalition of financial and medical professionals to find a way to remedy the situation. The coalition is called the “Elder Investment Fraud and Financial Exploitation Project.”
Because a financial fleecing causes stress which causes further ailments from their financial woes, Baylor College of Medicine came up with a set of questions doctors could ask to determine if their elderly patients were suffering from “mild cognitive impairment.” It centers on the fact that approximately 33.3 percent of those over 70 become confused when dealing with numbers. The warning signs for seniors are:
• Confused over paying bills;
• A lack of confidence over making financial decisions alone;
• Confusion over others making their financial decisions;
• Making gifts they cannot afford;
• Assertions that someone is stealing money from them without any proof.
Of all these signs it is the assertion of money disappearing that seems to cause the most stress. They may get mixed up over numbers, but the thought that someone has accessed their account and money is disappearing is loathsome. They can’t eat or sleep or talk about anything else.
Once the doctors find the signs of mild cognitive impairment these tips lead to investigations and one financial planner got 99 years in prison. But the most successful way to prevent fraud on your relatives is to stay vigilant even if the care-giver doesn’t ask for it. In fact, particularly if the care-giver doesn’t ask for it.
The problem, or at least the biggest problem, is that the persons perpetrating the fraud are those that most people believe would be the last person to do it. It is that long, or so you thought, trusted friend that always came two or three times a week for tea. Or that sweet niece that always came over and washed that old neighbor’s towels, or his daughter who came from Arizona just to help him out.
Worse, it could be that care-giver paid by Medi-Cal who is suppose to do a job, only to show up with larceny in their heart once they understand how alone and alienated some older individuals can be made from the rest of society.
According to the Los Angeles Times, crediting a newly released survey, one senior in five has been taken in some form of financial con. It is exactly that one in five (20 percent chance) whom the con men and women are looking for to take advantage. If you say, “I’m looking for a ‘reverse mortgage’ on my house,” and they answer, “I have something better for you than a reverse mortgage!” -- followed by a pitch that is an incomprehensible financial alternative and all you understand is the bottom line, which of course sounds too good to be true and you believe it, then you are in trouble. The elder citizen that enjoyed talking with the polite man’s voice might think it must be their lucky day, when in fact it is the other way around.
Even people in their fifties do not realize how much money a seventy year old senior has stashed away as a result of frugal living and conservative investments. Not everyone is a crook, but the crooks are looking for these small fortunes saved by a man who sometimes has a day of dementia, or the elderly woman who was not thinking clearly only because she had started a new medication routine.
All this led to some security regulators working for the Texas Securities Commissioner to discover that a disproportionate number of elderly fraud victims were suffering from some level of dementia. This led them to wonder if there were any red flags that may be seen on these vulnerable elders that could be identified before they got fleeced.
They joined forces with Dr. Robert Roush of Baylor College of Medicine and formed a coalition of financial and medical professionals to find a way to remedy the situation. The coalition is called the “Elder Investment Fraud and Financial Exploitation Project.”
Because a financial fleecing causes stress which causes further ailments from their financial woes, Baylor College of Medicine came up with a set of questions doctors could ask to determine if their elderly patients were suffering from “mild cognitive impairment.” It centers on the fact that approximately 33.3 percent of those over 70 become confused when dealing with numbers. The warning signs for seniors are:
• Confused over paying bills;
• A lack of confidence over making financial decisions alone;
• Confusion over others making their financial decisions;
• Making gifts they cannot afford;
• Assertions that someone is stealing money from them without any proof.
Of all these signs it is the assertion of money disappearing that seems to cause the most stress. They may get mixed up over numbers, but the thought that someone has accessed their account and money is disappearing is loathsome. They can’t eat or sleep or talk about anything else.
Once the doctors find the signs of mild cognitive impairment these tips lead to investigations and one financial planner got 99 years in prison. But the most successful way to prevent fraud on your relatives is to stay vigilant even if the care-giver doesn’t ask for it. In fact, particularly if the care-giver doesn’t ask for it.
Wednesday, July 28, 2010
Should You Plan for Medi-Cal?
One of the biggest decisions you must make in structuring your estate plan a good five years before your perceived timing of prolonged medical care — as in three months of hospital and rehabilitation care, or long-term skilled nursing care, or the co-payment of the balance on the portion Medicare will pay when you turn 65 years old — is whether you should apply for Medi-Cal.
If you’re indigent, you need not worry. But if you plan to make yourself indigent in order to apply for Medi-Cal, then this is serious business.
Medi-Cal has a five-year “look-back’’ to make certain you didn’t give your wealth away in questionable transactions to siblings, friends, trusts or the wrong kind of irrevocable trust in order to make your estate indigent. The application form is a test of your time, diligence and bookkeeping abilities just to get your foot in the door. Any and every transaction in the past five years must be verified on both ends to make certain of its legitimacy. Then you must reapply every year in a shorter form, but usually face to face with your case worker.
If your application isn’t verified, you will be penalized by a formula based on how much money you gave away (which was not exempt) in order to get your estate down to the $2,000 minimum in liquid assets. The penalty is the amount of time you will remain ineligible before you are able to reapply for Med-Cal. It may be months or years, which means you are almost certain to be indigent by the time you are eligible — given the cost of surgeries and skilled medical care.
Why would someone plan to become indigent? The simple answer in the general case is that at 65 years old (some choose 62), you begin to draw Social Security benefits based on the amount of money and years you paid into the program. With this monthly financial stipend, you automatically can sign up for the federal Medicare health insurance benefits. If you had very poor insurance coverage, or no coverage at all, Medicare will greatly reduce the cost of your health care — but it doesn’t pay for it all. There is a long range of co-pays for which you are personally responsible to pay. But if you also have Medi-Cal, it will cover the co-pay for you.
California’s system of comprehensive medical coverage is different from any other Medicaid coverage in the other states. Unfortunately, there aren’t counselors standing in line to help the elderly understand what they should do because it is so complicated in its conflicts with many of the benefits from Medicare that you could do more harm than good in some cases. Medi-Cal is not for everyone, and it would be ill-advised to recommend it. The application takes initiative — and sometimes it’s too late.
Medicare is an offspring of the Social Security Administration and intertwines with that agency so much that if you did start receiving benefits at 62, you automatically become entitled to the health insurance program at age 65. Medicare provides some — but not all — the benefits you may need to pay for a $500-a-night stay in the hospital, particularly longer than 100 days. That’s why there is Medi-Cal.
As for Medicare, if you postpone signing up for Medicare when you’re 65, and continue to work and stay with your employer’s health-care plan, you have made your eligibility options for Medicare when you do retire much more complicated and limited. You can’t just sign up when you feel like it. There are deadlines that must be met. If you want the least hassle, apply during the seven-month enrollment period beginning three months before your birthday month and three months after — giving you seven months.
But you must be aware of what you’re getting from Medicare. It’s broken down into four parts. Part A covers hospitalization for free for those age 65 or older, before the co-pay. Part B covers doctor visits and other forms of outpatient care, but this is based on specific needs and the environment in which you live. You can be certain that it will not be sufficient to cover all of your costs. It keeps skilled nursing and home caregiver hours to an absolute minimum. After that, you either pay for it yourself, which is impossible if you have only $2,000, you have insurance to pay for it or you’re taken to a home from which your chances of returning to your own home are very slim.
Part C is an individual “Advantage” plan from Medicare that A and B don’t cover and for which the individual pays a premium. If you can work that out while being on Medi-Cal, you have accomplished more than most people can do; and Part D, etc.
Generally speaking, medical expenses for nearly all seniors in California are covered by Medicare, supplemental insurance, HMOs, veterans benefits, Medi-Cal and any combination of those. You can file for Medicare and be eligible for the benefits, even if you’re still working and even if you’re not collecting Social Security.
Medi-Cal is a combined federal and state program that pays for health care and long-term care for eligible low-income citizens and legal residents of the United States. Some people receive both Medicare and Medi-Cal; many do not.
Whatever the case for you or those you love, winding through the maze of limitations and benefits needs more than a treasure map. You need an attorney trained by the National Academy of Elder Law Attorneys, the National Elder Law Foundation or a California State Bar specialist in estate planning and probate in the Elder Law Section.
— No opinion herein is a “marketed opinion” and no information provided herein can be used to avoid tax penalties for which the taxpayer would otherwise be responsible. I have lived in Santa Barbara for more than 30 years and practiced law here for 25 years. My book, Estate Planning: The Heroes Way for Baby Boomers, can be purchased via my Web site, www.MarkCornwall.com; Amazon.com; or locally at Chaucer’s and Borders bookstores. To schedule an appointment, contact me at mark@babyboomerpublishing.com or 805-845-7558.
If you’re indigent, you need not worry. But if you plan to make yourself indigent in order to apply for Medi-Cal, then this is serious business.
Medi-Cal has a five-year “look-back’’ to make certain you didn’t give your wealth away in questionable transactions to siblings, friends, trusts or the wrong kind of irrevocable trust in order to make your estate indigent. The application form is a test of your time, diligence and bookkeeping abilities just to get your foot in the door. Any and every transaction in the past five years must be verified on both ends to make certain of its legitimacy. Then you must reapply every year in a shorter form, but usually face to face with your case worker.
If your application isn’t verified, you will be penalized by a formula based on how much money you gave away (which was not exempt) in order to get your estate down to the $2,000 minimum in liquid assets. The penalty is the amount of time you will remain ineligible before you are able to reapply for Med-Cal. It may be months or years, which means you are almost certain to be indigent by the time you are eligible — given the cost of surgeries and skilled medical care.
Why would someone plan to become indigent? The simple answer in the general case is that at 65 years old (some choose 62), you begin to draw Social Security benefits based on the amount of money and years you paid into the program. With this monthly financial stipend, you automatically can sign up for the federal Medicare health insurance benefits. If you had very poor insurance coverage, or no coverage at all, Medicare will greatly reduce the cost of your health care — but it doesn’t pay for it all. There is a long range of co-pays for which you are personally responsible to pay. But if you also have Medi-Cal, it will cover the co-pay for you.
California’s system of comprehensive medical coverage is different from any other Medicaid coverage in the other states. Unfortunately, there aren’t counselors standing in line to help the elderly understand what they should do because it is so complicated in its conflicts with many of the benefits from Medicare that you could do more harm than good in some cases. Medi-Cal is not for everyone, and it would be ill-advised to recommend it. The application takes initiative — and sometimes it’s too late.
Medicare is an offspring of the Social Security Administration and intertwines with that agency so much that if you did start receiving benefits at 62, you automatically become entitled to the health insurance program at age 65. Medicare provides some — but not all — the benefits you may need to pay for a $500-a-night stay in the hospital, particularly longer than 100 days. That’s why there is Medi-Cal.
As for Medicare, if you postpone signing up for Medicare when you’re 65, and continue to work and stay with your employer’s health-care plan, you have made your eligibility options for Medicare when you do retire much more complicated and limited. You can’t just sign up when you feel like it. There are deadlines that must be met. If you want the least hassle, apply during the seven-month enrollment period beginning three months before your birthday month and three months after — giving you seven months.
But you must be aware of what you’re getting from Medicare. It’s broken down into four parts. Part A covers hospitalization for free for those age 65 or older, before the co-pay. Part B covers doctor visits and other forms of outpatient care, but this is based on specific needs and the environment in which you live. You can be certain that it will not be sufficient to cover all of your costs. It keeps skilled nursing and home caregiver hours to an absolute minimum. After that, you either pay for it yourself, which is impossible if you have only $2,000, you have insurance to pay for it or you’re taken to a home from which your chances of returning to your own home are very slim.
Part C is an individual “Advantage” plan from Medicare that A and B don’t cover and for which the individual pays a premium. If you can work that out while being on Medi-Cal, you have accomplished more than most people can do; and Part D, etc.
Generally speaking, medical expenses for nearly all seniors in California are covered by Medicare, supplemental insurance, HMOs, veterans benefits, Medi-Cal and any combination of those. You can file for Medicare and be eligible for the benefits, even if you’re still working and even if you’re not collecting Social Security.
Medi-Cal is a combined federal and state program that pays for health care and long-term care for eligible low-income citizens and legal residents of the United States. Some people receive both Medicare and Medi-Cal; many do not.
Whatever the case for you or those you love, winding through the maze of limitations and benefits needs more than a treasure map. You need an attorney trained by the National Academy of Elder Law Attorneys, the National Elder Law Foundation or a California State Bar specialist in estate planning and probate in the Elder Law Section.
— No opinion herein is a “marketed opinion” and no information provided herein can be used to avoid tax penalties for which the taxpayer would otherwise be responsible. I have lived in Santa Barbara for more than 30 years and practiced law here for 25 years. My book, Estate Planning: The Heroes Way for Baby Boomers, can be purchased via my Web site, www.MarkCornwall.com; Amazon.com; or locally at Chaucer’s and Borders bookstores. To schedule an appointment, contact me at mark@babyboomerpublishing.com or 805-845-7558.
Wednesday, July 21, 2010
Estate Planning Preferable to the Crisis Before Dying
The difference between the theory of estate planning well in advance and the reality of dealing with a mother, father, sister, brother or child dying can’t be measured in money or emotion. It’s not until you have to put that plan into effect that you begin to understand its absolute necessity.
The only thing worse is to get to those days of a sudden emergency that eventually causes a death only to find out that the estate plan isn’t valid, either because it doesn’t represent the person’s last wishes or because events have changed in the life of the trustee/testator that makes the old revocable trust or last will and testament invalid.
This not only would cause you to revoke the old revocable trust and transfer the real estate in that trust back to the original trustee, but then to create a new revocable trust or will while the trustee/testator is still alive and competent — making sure it is accomplished before the trustor/trustee dies.
This requires extraordinary haste in drawing up the legalities necessary to perform this documentary feat, which means it’s never going to be cheap — unless someone in the family is an estate planning attorney. It begins with the durable power of attorney to manage personal financial affairs meant to aid those who can’t make it to the bank.
As we have discussed, if the bank doesn’t know you, it will only provoke an argument as to what the trustor wants done. Normally the resolve can end with the bank manager who has personally heard it from the trustor’s mouth. But some banks, such as the Bank of America in one known incident, will give you only the fax number to their legal department to send the document and letter of explanation, and you don’t get called back without more diligence until weeks later.
But putting the legal documents aside, the even bigger challenge is having to deal with the social services such as Social Security, Medicare and Medi-Cal, which hopefully have been put in place, and will be if the patient is 65 years old or older.
Those first two federal agencies are a godsend when it comes to the aid of the exorbitant cost of getting your loved one the vital surgeries that must be performed immediately to save the patient’s life. There will be no three weeks to wait for Anthem Blue Shield to give the OK, presuming the patient is lucky enough to have insurance.
If the patient is in the hospital longer than 72 hours, Medicare also will help pick up a portion of the tab for 24-hour health care at the rehabilitation center. But the margin on the balances of the medical bills during this period, which can be months, are expected to be paid by the patient —or, depending on their financial status, it will have to come from your pocket.
However, there is the third resource, Medi-Cal, if the patient is indigent, meaning he doesn’t have more than $2,000 in cash or doesn’t have private insurance to pick up the “co-pay” after Medicare has paid its share of the medical cost.
Medi-Cal is California’s version of the federal Medicaid program, and it must be approached very cautiously because California’s rule and regulations as to which applicants can qualify for benefits conflicts with many of the rules regarding Social Security’s Medicare. In many cases, it will turn out that you can’t qualify for both. If you have planned ahead and do qualify for both, then you have the best insurance available.
But for many who could use it, the mere filling out of the application for medical insurance is so daunting a task, fraught with the requirement of verifying every asset regarding its cost and value, along with filling out the statement of facts by stating just the right things, that clients would rather get an ulcer over starving to death than getting one filling out the application form for Medi-Cal.
This short article is not capable of walking a reader through the complications and review system that is required every year. The best advice is to plan this insurance resource well in advance of the five-year “look-back” by the agency at the time the application is filed to determine when you would be eligible.
Other than that, keep living a healthy lifestyle of exercise and nutrition, and good luck.
The only thing worse is to get to those days of a sudden emergency that eventually causes a death only to find out that the estate plan isn’t valid, either because it doesn’t represent the person’s last wishes or because events have changed in the life of the trustee/testator that makes the old revocable trust or last will and testament invalid.
This not only would cause you to revoke the old revocable trust and transfer the real estate in that trust back to the original trustee, but then to create a new revocable trust or will while the trustee/testator is still alive and competent — making sure it is accomplished before the trustor/trustee dies.
This requires extraordinary haste in drawing up the legalities necessary to perform this documentary feat, which means it’s never going to be cheap — unless someone in the family is an estate planning attorney. It begins with the durable power of attorney to manage personal financial affairs meant to aid those who can’t make it to the bank.
As we have discussed, if the bank doesn’t know you, it will only provoke an argument as to what the trustor wants done. Normally the resolve can end with the bank manager who has personally heard it from the trustor’s mouth. But some banks, such as the Bank of America in one known incident, will give you only the fax number to their legal department to send the document and letter of explanation, and you don’t get called back without more diligence until weeks later.
But putting the legal documents aside, the even bigger challenge is having to deal with the social services such as Social Security, Medicare and Medi-Cal, which hopefully have been put in place, and will be if the patient is 65 years old or older.
Those first two federal agencies are a godsend when it comes to the aid of the exorbitant cost of getting your loved one the vital surgeries that must be performed immediately to save the patient’s life. There will be no three weeks to wait for Anthem Blue Shield to give the OK, presuming the patient is lucky enough to have insurance.
If the patient is in the hospital longer than 72 hours, Medicare also will help pick up a portion of the tab for 24-hour health care at the rehabilitation center. But the margin on the balances of the medical bills during this period, which can be months, are expected to be paid by the patient —or, depending on their financial status, it will have to come from your pocket.
However, there is the third resource, Medi-Cal, if the patient is indigent, meaning he doesn’t have more than $2,000 in cash or doesn’t have private insurance to pick up the “co-pay” after Medicare has paid its share of the medical cost.
Medi-Cal is California’s version of the federal Medicaid program, and it must be approached very cautiously because California’s rule and regulations as to which applicants can qualify for benefits conflicts with many of the rules regarding Social Security’s Medicare. In many cases, it will turn out that you can’t qualify for both. If you have planned ahead and do qualify for both, then you have the best insurance available.
But for many who could use it, the mere filling out of the application for medical insurance is so daunting a task, fraught with the requirement of verifying every asset regarding its cost and value, along with filling out the statement of facts by stating just the right things, that clients would rather get an ulcer over starving to death than getting one filling out the application form for Medi-Cal.
This short article is not capable of walking a reader through the complications and review system that is required every year. The best advice is to plan this insurance resource well in advance of the five-year “look-back” by the agency at the time the application is filed to determine when you would be eligible.
Other than that, keep living a healthy lifestyle of exercise and nutrition, and good luck.
Wednesday, July 14, 2010
Planning Pays Off When Leaving Money to Children
Strangely enough, last week’s column — which reveled in the fulfillment of those who are able to reconcile their sibling rivalry before they die — nevertheless prompted a number of calls from potential clients who are unable to reconcile the rivalry with their brothers or sisters.
Each of them had a story based on alleged fraud and deceit regarding the handling of their parents’ revocable trusts.
In every case, the theme was that an older or younger sibling had somehow gained control over the disbursement of funds in the trust in an attempt to cut a brother or sister out of the percent of the assets they were apparently due under the trust. These children had not reached that epiphany of realizing the only thing that matters when you near the pearly gates are those family members and others you love and who support you. Apparently that requires laying on your death bed.
But when it comes to the sibling rivalry after the parents are gone, it doesn’t so easily come to a halt. In fact, it grows worse because the siblings left behind still believe that money is more important than loving the sister you never got along with during the past 20 years. These cases are resolved only through litigation or arbitration.
However, this type of unforeseen rivalry can be easily avoidable by putting enough thought into your revocable trust during the course of your estate planning.
As for leaving money to children, there is much to take into consideration depending on the age and temperament of the child. The older you get, the more outrageous it seems to leave a large sum of money to an 18-year-old.
It is commonly recommended that a trust be used to stagger payments, possibly at ages 23, 26 and 30. The expectation is that at 23 your son will want to buy a Porsche, at 26 he will have graduated college, and at 30 he will have settled down and knows what he wants to do in life. For others, the ages of 20, 30 and 40 sound more appropriate.
Yet some parents may want to provide for their children’s education and then leave the rest of the money to charity. This is easily accomplished through a wonderful tax-saving device known as a charitable remainder unitrust (CRUT).
A CRUT is very flexible and will allow you to — among other things — sell stocks with a very low tax basis at a very high price, and not pay any capital gains taxes on the appreciation of the stock. It works the same for highly appreciated real estate. As you will see, whether used to pay for the education of your children, or to provide a percentage of the income to you for retirement, a CRUT is a valuable tool in estate planning. (See Chapter 16 of my book for more details on CRUTs).
The normal prerequisite of a trust for children is that it protects the corpus (that amount of money in the trust) from them — thus the name “spendthrift trusts.”
Another way of helping young adults manage money, rather than keeping it from them or forcing it on them, is to allow them to withdraw money from the trust as they believe they need it. This essentially allows them to be their own trustee without the responsibility of managing the entire sum of money in the trust.
Another way to manage children’s money is to establish a family pot trust that can be distributed to each child in accordance with his or her needs, according to the trustee’s discretion or by the terms in the trust. Another way is a minor’s trust, and yet another is a custodial account — and there are more.
Therefore, as you can imagine, there are many ways to plan your child’s inheritance. Most parents are afraid a trust may be a distraction for a young person. They believe it might rob the children of their incentive to go out in the world and do well. More than one child has been lured away from college or taken up a life of drugs because the easy money was there with no conditions required before getting the money.
These concerns can be relieved by language in the trust that stops money when the child is not enrolled in college full time, fails to maintain a certain grade point average, gets arrested more than once or violates some other standard of conduct that was outlined in the trust.
Each of them had a story based on alleged fraud and deceit regarding the handling of their parents’ revocable trusts.
In every case, the theme was that an older or younger sibling had somehow gained control over the disbursement of funds in the trust in an attempt to cut a brother or sister out of the percent of the assets they were apparently due under the trust. These children had not reached that epiphany of realizing the only thing that matters when you near the pearly gates are those family members and others you love and who support you. Apparently that requires laying on your death bed.
But when it comes to the sibling rivalry after the parents are gone, it doesn’t so easily come to a halt. In fact, it grows worse because the siblings left behind still believe that money is more important than loving the sister you never got along with during the past 20 years. These cases are resolved only through litigation or arbitration.
However, this type of unforeseen rivalry can be easily avoidable by putting enough thought into your revocable trust during the course of your estate planning.
As for leaving money to children, there is much to take into consideration depending on the age and temperament of the child. The older you get, the more outrageous it seems to leave a large sum of money to an 18-year-old.
It is commonly recommended that a trust be used to stagger payments, possibly at ages 23, 26 and 30. The expectation is that at 23 your son will want to buy a Porsche, at 26 he will have graduated college, and at 30 he will have settled down and knows what he wants to do in life. For others, the ages of 20, 30 and 40 sound more appropriate.
Yet some parents may want to provide for their children’s education and then leave the rest of the money to charity. This is easily accomplished through a wonderful tax-saving device known as a charitable remainder unitrust (CRUT).
A CRUT is very flexible and will allow you to — among other things — sell stocks with a very low tax basis at a very high price, and not pay any capital gains taxes on the appreciation of the stock. It works the same for highly appreciated real estate. As you will see, whether used to pay for the education of your children, or to provide a percentage of the income to you for retirement, a CRUT is a valuable tool in estate planning. (See Chapter 16 of my book for more details on CRUTs).
The normal prerequisite of a trust for children is that it protects the corpus (that amount of money in the trust) from them — thus the name “spendthrift trusts.”
Another way of helping young adults manage money, rather than keeping it from them or forcing it on them, is to allow them to withdraw money from the trust as they believe they need it. This essentially allows them to be their own trustee without the responsibility of managing the entire sum of money in the trust.
Another way to manage children’s money is to establish a family pot trust that can be distributed to each child in accordance with his or her needs, according to the trustee’s discretion or by the terms in the trust. Another way is a minor’s trust, and yet another is a custodial account — and there are more.
Therefore, as you can imagine, there are many ways to plan your child’s inheritance. Most parents are afraid a trust may be a distraction for a young person. They believe it might rob the children of their incentive to go out in the world and do well. More than one child has been lured away from college or taken up a life of drugs because the easy money was there with no conditions required before getting the money.
These concerns can be relieved by language in the trust that stops money when the child is not enrolled in college full time, fails to maintain a certain grade point average, gets arrested more than once or violates some other standard of conduct that was outlined in the trust.
Subscribe to:
Posts (Atom)
