Saturday, December 31, 2011

Old Age and End of Life

By age 85, the average remaining life expectancy for Americans is six years. An 85-year-old has a 75 percent chance of living another three years, but only a one in four chance of surviving for 10. Which category a particular old person falls into has much to do with the medical problems he or she has, or doesn’t have, and with his or her ability to function.

When the odds are that they have only a few remaining years, should doctors discuss that with them? These issues were discussed in a recent article in the New England Journal of Medicine, Dr. Smith, a palliative care specialist at the University of California, San Francisco suggested offering to discuss “overall prognosis,” doctorspeak for probable life expectancy and the likelihood of death, with patients who don’t have terminal illnesses. The researchers favor broaching the subject with anyone who has a life expectancy of less than 10 years or has reached age 85.  Dr. Smith and his co-authors, Dr. Brie Williams and Dr. Bernard Lo — a geriatrician and an internist, said “This is about empowering patients to make informed choices and encouraging individual decision-making,”

“Advanced age itself is the greatest predictor of poor prognosis,” said, Dr. Smith and when patients they do think about it, Dr. Smith continued, “they want to get their finances in order, plan for long-term care, spend time with children and friends.” They may be able to take fewer medications and undergo fewer procedures, with the emphasis on quality of life, or otherwise shift priorities.

Read about this  in the New York Times at  http://newoldage.blogs.nytimes.com/2011/12/29/the-unspoken-diagnosis-old-age/?partner=rss&emc=rss
 
William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Monday, December 26, 2011

New Drugs Raise Hope for Patients With M.S.

After decades of basic research on M.S., the last five years have brought a rapid rollout of new and sophisticated drugs that are changing how this disease is managed and offering patients new hope.“We have a disease that’s gone from having no treatments 20 years ago to having multiple treatment options,” said Dr. Timothy Coetzee, the chief research officer at the National Multiple Sclerosis Society. “There is a growing recognition that M.S. is becoming a manageable disease.” 

There have also been advances in treating specific symptoms of M.S. Within the past two years, three medications have been approved specifically for M.S. symptoms: Ampyra to improve walking, Nuedexta for uncontrollable laughing or crying, and Botox for urinary incontinence and spasticity in upper limbs. 

Just last year, the first oral drug for M.S., Gilenya, gained approval with data showing it cut the relapse rate by 55 percent. Gilenya causes inflammatory cells called lymphocytes to get trapped in lymph nodes so they don’t travel to the brain, where they would damage neurons.Patients need to be monitored for several potentially serious side effects, including a slowed heart rate and liver and vision problems. One patient recently died 24 hours after starting on Gilenya; the Food and Drug Administration is investigating the cause of the death.

The most potent drug, Tysabri, reduces the relapse rate by about 70 percent, but it comes with a small risk of a fatal brain infection caused by a common virus. Patients may be screened for antibodies to the virus; the risk of infection is considered quite low in those with no sign of the antibodies, and they are given the drug.
At least four other drugs with different mechanisms are in Phase 3 clinical trials and could win approval within the next year, experts say. Some work by protecting nerves from damage.

Read about this in Laurie Tarkan's article in the New York Times at  http://www.nytimes.com/2011/12/27/health/new-drugs-raise-hope-for-patients-with-ms.html?partner=rss&emc=rss
 
William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.
  


  

Friday, December 16, 2011

Lawmakers Offer Bipartisan Plan to Overhaul Medicare

A Democratic senator, Ron Wyden of Oregon, and a Republican member of the House, Paul D. Ryan of Wisconsin, unveiled a bipartisan plan on Wednesday to revamp Medicare and make a fixed federal contribution to the cost of coverage for each beneficiary. 
 
Under the proposal, known as premium support, Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government. Congress would establish an insurance exchange for Medicare beneficiaries. Private plans would compete with the traditional Medicare program and would have to provide benefits of the same or greater value. The federal contribution in each region would be based on the cost of the second-cheapest option, whether that was a private plan or traditional Medicare. 

Unlike the Ryan budget blueprint approved by the House in April, Mr. Ryan said, the new proposal would preserve the traditional fee-for-service Medicare program as an option for all beneficiaries. “Our proposal harnesses the power of competition to address the root cause of medical inflation,” said Mr. Ryan, the chairman of the House Budget Committee.

This something to consider. Read about it in the NY Times at  http://www.nytimes.com/2011/12/15/us/politics/lawmakers-offer-bipartisan-plan-to-overhaul-medicare.html?_r=1
  
William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Thursday, December 15, 2011

SSA to study it's Judges

The Social Security Administration has commissioned an independent review of the federal disability system amid concerns it awards benefits to those who don't deserve them and denies benefits to those who do.
A focus of the study is expected to be the work of roughly 1,500 administrative-law judges, who hear appeals by applicants but whose award rates vary widely.

The administrative-law judges, who work for the Social Security Administration, are essentially appointed for life and have wide discretion to award or deny benefits based on their interpretation of each case.
One such judge, in Houston, awarded benefits in 13% of his cases last year, according to federal data, while another judge, in Kingsport, Tenn., awarded benefits in 99% of his decisions. The average approval rate is around 60%.

A draft of the study is due in August and the final recommendations are to be released in November. The recommendations won't be binding, but they could serve as a blueprint for changes by either the SSA or Congress.

Another focus of the study will be why federal courts are overturning many of the decisions that Social Security judges make when they deny benefits. In 2010, federal courts overturned or found errors in 51% of the roughly 12,000 Social Security appeals they decided, according to Robert Rains, a law professor at Penn State University. 
Read about this in Damian Paletta's article in the Wall Street Journal  at  http://online.wsj.com/article/SB10001424052970204844504577098810070396878.html?mod=rss_Health
Before a case can be appealed to Federal Court the Social Security internal appeal process to it's Appeals Council must be completed and the appeal rejected by the Appeals Council. My opinion about why the federal courts are overturning more cases appealed to the Courts is that the Appeals Council has been significantly expanded in an effort to decrease the the backlog of cases and .less qualified people are reviewing decisions. As a result, more cases at the Appeals Council with errors are coming through giving attorneys no alternative than appealing to the federal court poor decisions.   
 
 
William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.






Wednesday, December 14, 2011

Surprise! Surprise!----Mystery ALJ's

The "new policy" is that attorneys will no longer be notified of the identity of the Administrative Law Judge who will hear their clients' cases prior to the hearing. The only way you will find out the name of the ALJ is when you get to the ODAR and find out the name of the Judge to whom the case has been assigned. There was a story in the Wall Street Journal where an unnamed source indicated this was coming. This will discourage attorneys from taking certain claimant's cases just before the hearing. There are ALJ's that certainly have their bias in favor or against certain claimants based on the nature of their disabilities or past history. We all wish all of our clients were Mother Theresa but there are lot of nonfunctional people out there that have been victims of abuse, had criminal, mental health problems or have had substance abuse problems in their past. These claims are not settled as you must convince the ALJ that your client is disabled. Does knowing who the ALJ is make a difference as to whether you will take a case just before the hearing --of course.  What is going to be a tough case with a ALJ who has an allowance rate a little above average is going to be impossible with the toughest ALJ in the hearing office.  Nobody wants to bang their head against the wall.


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Thursday, December 8, 2011

Medicine is recognizing spiritual support is important

Chaplains are seeking bigger roles in hospitals and in some cases joining the medical-care team, as new research shows positive spiritual guidance and discussion can help improve a patient's medical outcome. Medical schools are adding courses on spirituality and health, and training residents to consider patients' spiritual needs. Some two-thirds of U.S. hospitals provide chaplaincy services; others rely on local clergy and lay volunteers.

 Studies indicate as many as 40% of patients with serious illnesses like cancer struggle with spiritual concerns, which can harm emotional and physical well-being, says George Fitchett, research director in the Department of Religion, Health and Human Values at Rush University Medical Center Chicago. 

Read more about this in an interesting article at Wall Street Journal at  http://online.wsj.com/article/SB10001424052970204826704577074462494881428.html?mod=rss_Health
 
William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.









Monday, December 5, 2011

Retirement Savings-Need to Catch Up?

The most effective way to build a retirement cushion after a late start is a combination of being aggressive about saving money, putting off retirement and taking Social Security as late as possible.The place to start is by being aggressive about saving. More is always better, but even relatively small amounts of money can make a difference. And with the kids out of college and hopefully out of the house, being disciplined about budgeting and potentially downsizing a home sooner rather than later could free up helpful amounts of money from each paycheck.


The other big boost can come from delaying retirement. Putting off retirement allows more time to save, more time for those savings to grow and fewer years of retirement to cover with savings.The benefit of delaying retirement can be magnified by holding off on taking Social Security benefits until age 70. 
"Even a few years can make a huge difference," says Yan Zilbering, an analyst in Vanguard's investment strategy department.Where the real leverage takes place, however, is the combination of increased savings and delayed retirement.Boosting that savings rate also provides a cushion should plans to retire later not pan out because of involuntary job loss or health changes. Read the article to learn.

Read about this in Tom Lauricella article in the Wall Street Journal Star at   http://online.wsj.com/article/SB10001424052970204012004577070421181765932.html?mod=rss_Retirement_Planning

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox in Central Illinois.

Saturday, December 3, 2011

42 Million Family Caregivers and Counting

Read an interesting story about the fact people we run into every day are being challenged as family caregivers for their elderly parents. You are not alone and hopefully there is some comfort in knowing that and that others are out there to talk to and vent.

newoldage.blogs.nytimes.com/2011/12/02/we-are-everywhere/?partner

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com

Serving Peoria, East Peoria, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox in Central Illinois.