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"Why Every Attorney Should Consider Medicaid Planning Issues When Settling Personal Injury Claims”

The Louisiana State Bar Association Journal, August/September 2007

 

            A client seeks your assistance with regard to representing him in a personal injury claim. He is 27and has been disabled as a result of serious injuries sustained in an automobile accident.  He is unable to work as a result of his disabilities.  He also has no health insurance and is unable to obtain health coverage.  He relies exclusively upon benefits he receives from Medicaid to pay for his medical treatment.  He receives Medicaid by virtue of the fact that he is eligible for Supplemental Security Income (SSI).  His medical treatment requires regular ongoing medical visits and related therapies. 

 

            Later, you are able to settle his personal injury claim for $200,000.  Release documents are executed and you disburse settlement proceeds directly to your client; however, months later, your client receives notice from SSI that he now has too much in financial resources because of the funds received in the personal injury settlement, and he is no longer eligible for SSI.  Further, since he was receiving Medicaid benefits as a result of his eligibility for SSI, he loses his Medicaid card as well.  Medicaid also demands reimbursement of amounts previously paid in benefits to him out of settlement funds that have been received.            

           

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“Estate Planning for the Disabled: An Overview of Special Needs Trusts”

The Lafayette Bar Association Promulgator, June 2001

 

            The front page of the May 14, 2001 issue of the Daily Advertiser contained several articles concerning bills currently being considered by Congress to provide tax relief to families with children with special needs.  As the father of a nine-year-old Downs Syndrome child, the article was certainly of interest to me.  The articles included statistics from the US Census Bureau indicating that in 1990, 29.1% of Louisiana’s under age 18 population was disabled.  According to a July 1998 study reported in Pediatrics Journal, nationally 18% of children under 18 years old (12.6 million children) in 1994 had chronic physical, developmental, behavioral or emotional conditions requiring special care.

 

            As I found out shortly after my second daughter was born in 1992, the unusual medical expenses associated with having a disabled child can be quite significant.  Since in many instances disabled children are not eligible for health insurance, public health programs such as Medicaid provide a lifeline for families trying to cope with such expenses.  In Louisiana, for example, the Community Home-based Waiver Program provides Medicaid and respite benefits to eligible families with disabled children without regard to needs-based qualifications concerning the income and assets of the parents that are normally associated with Medicaid.  These programs provide needed health coverage for special needs individuals that they often cannot obtain through private health insurance carriers, and also provide personal care attendants and babysitters to assist with these children.  However, qualifying for Medicaid through the community home-based waiver program can be a difficult and trying experience.

 

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DISCLAIMER

These articles have been prepared for general informational purposes only.  They are not intended to, and do not, constitute legal advice.  Use of these materials does not create or constitute an attorney-client relationship.