Thursday, December 30, 2010

Medicare-You think you have paid your share-Wrong!

Consider an average-wage, two-earner couple together earning $89,000 a year. Upon retiring in 2011, they would have paid $114,000 in Medicare payroll taxes during their careers.But they can expect to receive medical services — from prescriptions to hospital care — worth $355,000, or about three times what they put in.. Many workers may believe their Medicare payroll taxes are going for their own insurance after they retire, but the money is actually used to pay the bills of seniors currently on the program.

The estimates by economists Eugene Steuerle and Stephanie Rennane of the Urban Institute think tank illustrate the huge disconnect between widely-held perceptions and the numbers behind Medicare's shaky financing. Although Americans are worried about Medicare's long-term solvency, few realize the size of the gap. The system has worked for 45 years, with occasional fine tuning. But the retirement of the baby boomers, the first of whom become eligible for Medicare in 2011, threatens to push it over the edge."With Medicare, we are all still making out like bandits, shoving all those costs to future generations," said Steuerle. "At another level, we know that this system is totally unsustainable." 
Read all about this in an article by AP press for Yahoo News. at

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability lawyer

Wednesday, December 29, 2010

Social Security Disability issues-Fibromyalgia Study shows Mindfulness Therapy no help

Fibromyalgia is a syndrome marked by widespread pain -- including discomfort at specific "tender points" in the body -- along with symptoms like fatigue, irritable bowel and sleep problems. It is estimated to affect up to 5 million U.S. adults, most commonly middle-aged women.The precise cause of fibromyalgia is unknown. There are no physical markers, like inflammation or tissue damage in the painful areas -- but some researchers believe the disorder involves problems in how the brain processes pain signals. Standard treatments include painkillers, antidepressants, cognitive-behavioral therapy and exercise therapy. However, many people with fibromyalgia find that their symptoms persist despite treatment. One reason, some researchers suspect, may be because standard treatments do not specifically address the role psychological stress and emotions can play in triggering pain.
The study, published in the journal Pain, looked at the effects of so-called mindfulness-based stress reduction -- a technique developed by researchers at the University of Massachusetts in 1979 that combines mindfulness meditation and gentle yoga postures.The technique is now available throughout the world -- in the form of an eight-week program of classes -- to help people manage general stress or health problems, including chronic pain.
For the new study, researchers led by Dr. Stefan Schmidt, of the University Medical Center in Freiburg, Germany, tested the program's effects among 177 women with fibromyalgia.They found that women assigned to the mindfulness program showed no greater gains in health-related quality of life than those assigned to a waiting list for treatment.That meant no significant improvements in either physical symptoms or emotional well-being.

Amy Norton writes about his for Reuters online service. Read about about at
William Wombacher, your Central Illinois Social Security Disability law attorney 

Saturday, December 25, 2010

U.S. Phases Out Social Security Checks -Disability & Social Security Retirement

The U.S. government is phasing out paper checks for these benefit programs, under a Treasury Department rule finalized Tuesday. The Treasury expects the shift to save Social Security $1 billion over the next 10 years.
Under the final plan, anyone applying for benefits on or after May 1, will receive their payments electronically. People who already receive paper checks will need to switch to direct deposit by March 1, 2013.  

The government's new electronic-payment requirement has some exceptions. It has waived, for instance, for check-receiving recipients who are age 90 or older or approaching 90. Specifically, benefit recipients born before May 1, 1921, who would like to keep receiving paper checks will be able to do so under the final rule. In addition, the Treasury is touting its prepaid card, the Direct Express Debit MasterCard, for benefit recipients who don't choose direct deposit. More than 1.5 million beneficiaries have signed up for the card since it was introduced in 2008.

Read about this in the Wall Street Journal online

William Wombacher, Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Attorney 

Tuesday, December 21, 2010

Senior-on-Senior Financial Fraud

Jason Zweig and Mary Pilon write in the Wall Street Journal about the increasing frequency of Seniors taking financially advantage of other Seniors.In Louisiana,  Judith Zabalaoui, 73, pleaded guilty in February 2009 to five counts of mail fraud and is now serving an eight-year prison sentence after persuading at least 35 clients, many of them elderly, to invest in two nonexistent companies that promised "safe" returns of 13% to 26%. She had clients sign a power of attorney, giving her access to their funds—and spent more than $3 million of their money on her own expenses, including clothing and vacations, according to court documents. 

"That's a definite new trend," says Denise Voigt Crawford, the Texas securities commissioner. "We're seeing more cases of older people ripping off other older people. Someone joked that seniors ripping off their peers is becoming 'the new retirement plan.'" Some older financial advisers use their age as a selling point, telling clients they understand the challenges that older investors face. In many instances, say prosecutors, unscrupulous advisers also tout their professional designations, or credentials, as further evidence of their expertise. Ms.Zabalaoui, the Louisiana adviser, marketed herself as a CFP, say clients, even though her credential lapsed in 2000.

Read more about this at

William Wombacher, Central Illinois Certified Elder Law Attorney (CELA)   I'll help you!

Friday, December 17, 2010


As I have previously written, a very contentious issue with Medicare has been Medicare cutting off coverage for  home health care coverage when a patient is not improving. Medicare then classifies the patient as only needing custodial care as opposed to the skilled care which Medicare will provide coverage for up to the limits of the program. The Feds have been losing on this issue in Federal Court and are now responding.  The Centers for Medicare & Medicaid Services (CMS) issued new regulations on November 17th regarding coverage for home health services. The new regulations clarify Medicare coverage for home health services, including physical therapy, occupational therapy and speech-language pathology services.The regulations are effective January 1, 2011; however, since they clarify rather than change coverage rules, they are also applicable to services prior to that time. To determine whether a service is skilled, and therefore coverable, the new regulations direct decision-makers to review accepted standards of clinical practice and to consider whether a professional is needed for the service to be safe and effective for the particular beneficiary.

These considerations, rather than the ability to improve, are the key factors to be considered in making coverage determinations. The rules state that they do not alter coverage, but rather provide additional detail for care planning, assessment, and reassessment. They should help advocates in their efforts to ensure that necessary services are covered, particularly for people with chronic conditions.

Read all about this and more at the website of the Center for Medicare Advocacy at

William Wombacher , a Central Illinois Certified Elder Law Attorney (CELA). I'll help you!

Friday, November 12, 2010

MetLife Inc. said it will halt sales of long-term-care insurance

MetLife is among the bigger sellers of the coverage, with about 600,000 policyholders, or about 8%, among the eight million who have long-term-care insurance in the U.S., according to the company and an industry trade association.  Its $36 million in sales last year were dwarfed by perennial industry leaders John Hancock Financial, at $116 million, and Genworth Financial Inc., at $108 million, according to Broker World. John Hancock recently said it would ask state regulators for an average 40% increase for about 850,000 of its 1.1 million long-term-care policyholders. Allianz SE and Minnesota Life Insurance Co., a subsidiary of Securian Financial Group Inc., are among the companies that halted sales of long-term-care insurance in the last two years. Read more about this in the Wall Street Journal

William Wombacher, your Central Illinois Disability and Certified Elder Law Attorney (CELA)

Wednesday, November 10, 2010

2011 Part B Medicare premiums will not increase for most on Social Security

The majority of Medicare beneficiaries will not see an increase in their Part B premium because there will be no Social Security cost-of-living adjustment for 2011. They will continue to pay the same Part B premium, $96.40, which they paid in 2009 and 2010. A hold harmless provision in the Social Security Act disallows an increase in the Medicare Part B premium for qualifying Social Security recipients if their COLA is not large enough to cover the increase in the Part B premium.

Individuals who are new to Medicare in 2011 or who did not have Medicare premiums withheld from their Social Security or their Railroad Retirement checks in 2010 will pay $115.40. Individuals who pay the income-related Part B premium are not protected by the hold harmless clause. The amount of the premium they will pay depends on their modified adjusted gross income.  See the article below to determine if this effects you! 

Beginning in 2011, people who pay the income-related Part B premium will also pay an additional income-related Part D premium, known as a monthly adjustment amount. The monthly adjustment amount is not related to the premium of the plan in which such beneficiaries are enrolled.
The monthly adjustment amount will be paid directly to Medicare through withholding from Social Security checks. Beneficiaries who pay the Part D monthly adjustment amount will continue to pay their regular Part D premium to the drug plan in which they enroll. Read all about this and more at the Center for Medicare Advocacy website.
William Wombacher, your Central Illinois Disability and Certified Elder Law Attorney (CELA)

Tuesday, November 9, 2010

How much does the Fed government owe the SSA Trust Fund?

We all know the famous Social Security Trust Fund does not exist. Over the years Congress has spent every cent that came in and more to over their deficit spending.  They issued Treasury bills, notes and bonds to generate the cash that was not coming in from taxes and FICA. So the government created a bunch of IOU's to cover the money they spent that they didn't have. Have you ever wonder how much Congress would need to put into the Social Security Trust Fund in order to pay back with interest the money they used they spent which should have stayed in the Trust Fund. The answer according to the federal Government was 2.6 Trillion dollars. See for yourself.                             

William Wombacher, your Central Illinois Disability and Certified Elder Law Attorney (CELA)

Wednesday, November 3, 2010

Give back your social security check to get more money?

Hey, retirees: Looking for a way to bring in more money? Give back all the Social Security checks you have received so far.  An often-overlooked provision allows Social Security recipients to withdraw their original application for benefits and to refile. For many retirees already collecting benefits, the strategy—known informally as a "Social Security reset"—could sharply increase their monthly income. The reset strategy works because the Social Security system is wired to grow more generous the later one starts taking benefits. If you begin taking them early, meaning before your so-called full-retirement age, your benefit check shrinks by as much as 30%, depending on your year of birth. But for each year beyond full-retirement age that you still haven't claimed benefits, you earn credits of generally between 7% and 8% a year.

The strategy is particularly useful for retirees considering buying an immediate annuity, which, in return for a lump sum of cash, provides an immediate stream of monthly checks generally set up so a retiree won't outlive the money.

In most cases, "the income from resetting Social Security will greatly exceed the annuity income," says Charles Ryan, a certified financial planner in Annapolis, Md., who recently described the strategy in the Journal of Financial Planning.Determining on your own whether a reset will benefit you is a challenge because of the tax calculations and other issues. The best advice: Find a financial planner who understands this, or who has access to a computer program called ESPlanner that Mr. Kotlikoff helped design.

Learn more about this strategy in the Wall Street Journal

William Wombacher, your Central Illinois Disability and Certified Elder Law Attorney (CELA)

Tuesday, November 2, 2010

Doctors payments to be cut by Medicare on December 1

Unless Congress intervenes, payments to doctors for treating Medicare patients will be cut by 23 percent on Dec. 1 and another 6.5 percent on Jan. 1. In recent years, the payment formula has called for cuts, but each time lawmakers have stepped in to block them before they took effect or shortly afterward. In April, the Congressional Budget Office said that blocking the cuts until January 2012 would cost about $15 billion. A long-term formula fix, through 2020, would cost about $276 billion, it said.The American Medical Association is gearing up for the lame-duck congressional session scheduled to start Nov. 15. If nothing happens the tough decisions for physicians. The reality is between now and the end of December physicians have to make a decision about their status related to Medicare. Do they want to continue participating and take the cuts?

Read more about this in the Washington Post-

William Wombacher --- your Central Illinois Disability and Certified Elder Law Attorney

Monday, November 1, 2010

Medicare premiums can increase with an increase in income

Many retirees and their financial advisers don't realize that a perfectly reasonable investment decision can wind up costing thousands of dollars in Medicare premiums.The hit could last a year or more, but can often be avoided with proper planning. Ellen Schultz writes about this in the Wall Street Journal. Medicare Part B is medical insurance that covers doctors' services, outpatient care, physical therapy and some home health care.
Since 2007, higher-income beneficiaries have been required to pay an income-adjusted surcharge. In 2010, individuals with income of more than $85,000 a year, and couples with incomes above $170,000, pay an additional amount ranging from $44 to $243 a month per person. The maximum monthly Medicare Part B premium per person is $354 for singles with income above $214,000 and couples with income above $428,000.Medicare premiums are based on "modified adjusted gross income," which is adjusted gross income—that is, taxable income—and tax-exempt interest income. To determine the Medicare Part B premium, the Social Security Administration uses the recipient's most recent tax return. In 2010, the premiums are based on returns filed in 2009 for the 2008 tax year. Taxpayers who are planning to exercise stock options or make withdrawals from 401(k)s or other deferred-compensation retirement accounts or  re-balancing a portfolio can bump up income and thus Part B premiums. But the impact can be mitigated with proper planning, such as offsetting gains with losses.  Read about this in the Wall Street Journal.

William Wombacher, your Central Illinois Disability and Elder law Attorney


Friday, October 29, 2010

No Cost- of -Living increase in 2011 for Social Security recipients

That's right !There will be no cost-of-living increase in Social Security benefits effective for December 2010.

William Wombacher, your Disability and Elder Law Attorney for Central Illinois

Sunday, October 10, 2010

Older veterans with a history of post-traumatic stress disorder (PTSD) are at increased risk for developing dementia

For veterans with PTSD their risk of dementia was double that of veterans who did not have PTSD, including those who had received the Purple Heart, according to Mark E. Kunik, MD, MPH, of the Michael DeBakey VA Medical Center in Houston, and colleagues.    For the current study, Kunik and colleagues examined records of veterans seen at least twice from 1997 to 1999 in VA centers in the South Central U.S., who had either a diagnosis of PTSD at that time or had received the Purple Heart for combat-related wounds or injuries.
"It could be that cognitive impairment in PTSD is an early marker of dementia, PTSD is an independent risk factor for dementia, or PTSD and dementia share a common risk factor such as low cognitive reserves," Kunik and colleagues wrote.  Similar results were published earlier this year from another VA system-based data analysis. 
Read more about the study at this link,
This has implications for both for those seeking Social Security Disability(SSDI) or Supplemental Security Income (SSI) and  for our Elder law clients who are Veterans.

William Wombacher, Central Illinois Disability and Elder Law Attorney--I'll help you!

Friday, October 8, 2010

New medical device may help stroke victims recover use of legs

Stroke patients striving to walk normally may get a lift from a bionic leg developed by venture-backed Tibion Corp. Tibion’s device, worn around the leg during physical therapy, supplies the power needed to stand or walk, and may enable more intense therapy sessions. As strength and control returns, it assists the leg less. Tibion’s device, worn around the leg during physical therapy, supplies the power needed to stand or walk, and may enable more intense therapy sessions. As strength and control returns, it assists the leg less.
     The company’s product, which wraps around the leg and extends from the thigh to the ankle, amplifies a patient’s effort, adding just enough mechanical lift to enable him to stand or take a step. Sensors in the patient’s shoe detect weight distribution and trigger the robot to deliver the amount of assistance that a therapist has programmed in.  
Read all about in Wall St Journal

WilliamWombacher, Central Illinois Disability and Elder Law specialist--I'll help you!


Thursday, October 7, 2010

Elder Law-Medicare Part D- enrollment begins again

Medicare Part D Plans change every year. Premiums and deductibles may change, and, worst of all, beneficiaries may find drugs they need taken off their plans' formularies or made subject to new prior authorization rules and other restrictions. It is a necessity that beneficiaries and their helpers compare different plans before the Part D Annual Election Period from November 15 – December 31.

The Central Management Service projects that for 2011, 1.2 million beneficiaries will have to change plans as a result of plans leaving the market or reducing their service area.  The vast majority of people who will need to change, 925,000 of them, are in Private Fee for Service (PFFS) plans that have decided they no longer want to participate in Medicare as a result of additional requirements passed in the 2008 Medicare Improvement for Patients and Providers Act (MIPPA), not the recent health care reform law.  The changes from 2008 go into effect for the 2011 plan year.
Learn what you need to know to make the best decisions. See The Center for  Medicare Advocacy website.  

William Wombacher. Central Illinois Certified Elder Law Attorney (CELA)

Tuesday, October 5, 2010

Surgery to reduce risk of Stroke

    Surgery to remove plaque from clogged neck arteries lowered the risk of stroke in the long run, according to a study in the Lancet. Over time, plaques composed of cholesterol and debris accumulate on artery walls, narrowing them and restricting the flow of blood. In carotid arteries, which run up either side of the neck, this narrowing increases the likelihood of having a stroke. The surgery, known as carotid endarterectomy, is sometimes suggested for patients whose carotid arteries have narrowed by 60% to 90%, even in the absence of pre-stroke symptoms.

For patients older than 75, carotid endarterectomy didn't significantly reduce stroke risk. The relative benefits of the procedure may decrease as nonsurgical treatments, such as cholesterol-lowering medications, become more effective. 
Read all about it in the Wall Street Journal.

William Wombacher, Central Illinois only Certified Elder Law Attorney (CELA)

Sunday, October 3, 2010

Powers of Attorney-Don't wait too long!

    Powers of Attorney for Health Care and Powers of Attorney for Property are very powerful documents that can be used to avoid the need for Guardianship.  They must be signed while the person giving the power is still competent and understands the significance of what they are going in granting the power to an agent. Powers of attorney should only be granted to persons whom you trust and who are able and willing to carry out your wishes. Powers of attorney should almost never be granted to strangers or to people with competing business or personal interests or agendas. So, when should you get a power of attorney? The answer is now! You don't wait until you are having problems. Sometimes that is too late. Only wait if you know when you are going to have a stroke, heart attack or get a brain injury in an accident.

William Wombacher, Central Illinois' only Certified Elder Law Attorney (CELA)

Monday, September 27, 2010

Social Security changes language related to mental disorders

The Social Security Administration wants to start using the term “intellectual disability/mental retardation” in lieu of “mental retardation,” following a similar switch at other state and federal agencies across the country.
In a notice posted last month in the Federal Register, the Social Security Administration indicated that it wants to make the language change amid a series of updates to the agency’s eligibility criteria for those with mental disorders.
“The term ‘mental retardation’ has taken on negative connotations over the years, is offensive to many persons and results in misunderstandings about the nature of the disorder and the persons who have it. The term ‘intellectual disability’ is now widely used internationally and is gradually replacing ‘mental retardation’ in the United States,” the notice indicates as reason for making the change. Read more about it.

William Wombacher, your Central Illinois Social Security disability attorney

Sunday, September 19, 2010

Spinal-Fluid Test, an Early Warning on Alzheimer’s

Researchers report that a spinal fluid test can be 100 percent accurate in in identifying a signature level of abnormal proteins in patients with significant memory loss who went on to develop Alzheimer’s disease.
Researchers are finding simple and accurate ways to detect Alzheimer’s long before there are definite symptoms. In addition to spinal fluid tests they also have new PET scans of the brain that show the telltale amyloid plaques that are a unique feature of the disease. Sometimes patients with severe memory loss do not have the disease. Doctors might want to use the test in cases where they want to be sure of the diagnosis. And they might want to offer the test to people with milder symptoms who want to know whether they are developing the devastating brain disease.
The new study included more than 300 patients in their 70s, 114 with normal memories, 200 with memory problems and 102 with Alzheimer’s disease. Their spinal fluid was analyzed for amyloid beta, a protein fragment that forms plaques in the brain, and for tau, a protein that accumulates in dead and dying nerve cells in the brain.Nearly every person with Alzheimer’s had the characteristic spinal fluid protein levels. Nearly three quarters of people with mild cognitive impairment, a memory impediment that can precede Alzheimer’s, had Alzheimer’s-like spinal fluid proteins. And about a third of people with normal memories had spinal fluid indicating Alzheimer’s. Researchers suspect that those people will develop memory problems.

Read more about this in the New York Times

William Wombacher  your Central Illinois Certified Elder Law Attorney (CELA)

Friday, September 17, 2010

COPD Related Depression

COPD affects the airways and air sacs within the lungs, which makes breathing difficult and can result in a person becoming less active over time. An elderly person who has COPD will easily become depressed, when dealing not only with breathing difficulties but other age related problems.
The most common types of daily COPD medicines are:
  • Inhaler for daily maintenance - Bronchodilators help relax the muscles around the lungs’ breathing tubes. This reduces shortness of breath and makes breathing easier.
  • Steroids – Corticosteroids, taken in pill form or inhaler reduce swelling in breathing tubes to quickly make breathing easier. Not commonly for prolong use.
  • Oxygen Treatment - Severe COPD will reduce your lungs’ ability to put oxygen into your blood to be carried throughout your body. Martin’s oxygen level was measured to determine if he would need prescribed oxygen therapy. Oxygen is usually prescribed if the oxygen in the blood is low during sleep, exercise, or while not active. A respiratory therapist from an oxygen supply company or home health service can help with learning how to use oxygen. 
  • An important factor in depression and COPD management can be diet.
  • “A healthy diet can play an important role in the management and treatment of COPD.
    Finding the right diet can be tricky for people with chronic obstructive pulmonary disease (COPD), since they need to eat a healthy diet and maintain their optimal weight to keep COPD symptoms in check.” )Krisha McCoy, MS, Lindsey Marcellin, MD, MPH)
    Read more about it from the National Care Planning Council
William Wombacher

Funeral costs-Ideas on how to control

I found this interesting article from the Wall Street Journal smartmoney feature that you might find interesting. I'm not sure about buying a casket at Costco but certainly there are some ideas to consider.

William Wombacher