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Creating a trust - role of DDS in Texas

Establishing a trust can greatly aid special-needs individuals


OK, last roundup of "Things to Know." From a Sept. 26 piece entitled "Government Benefits for Special-Needs Individuals," a good look benefits' programs and a great idea for helping special-needs individuals--set up a trust for them:

Planning is paramount

[Although it is crucial] to ensure that you have adequate planning in place to preserve your child’s eligibility for government assistance, it is important for individuals to know what government benefits are available to a special-needs child and when these benefits are available. Because government programs can be confusing and . . . they change often, anyone seeking to learn more about receiving government benefits for a special-needs child should consult an attorney or review current documentation on eligibility from each individual government program.

Four programs for special-needs families: two not means-based

There are four relevant government benefit programs available to special-needs families. These are Supplemental Security Income (“SSI”), Medicaid, Medicare and Social Security Disability Insurance (“SSDI”). [Neither] SSDI [nor] Medicare are... means-based programs. In other words, there is no investigation into your finances to determine if you qualify for the program based on your income or your resources. Medicare is a form of sponsored health insurance available for the elderly and the disabled and SSDI is available to individuals and minors or special needs children of an individual who has died, retired or become disabled.A special-needs child who is under age 22 and who is not working can obtain SSDI benefits based on his or her parents’ prior earnings.

SSI, Medicaid are means-based

SSI and Medicaid are both means-based programs. Eligibility for those programs is based on financial need and strict requirements must be met prior to receiving benefits. Medicaid can provide in-home care, cost of hospitalization and nursing-home care as well as some housing benefits to recipients. A special-needs child can receive SSI, SSDI, Medicaid and Medicare all at the same time.

Creating a supplemental-needs trust

The distinction between means- and nonmeans-based programs is important to understand. [Because] these benefits add greatly to a disabled person’s ability to receive care, and given the expensive cost of long-term medical and nursing care, anyone seeking to give a special-needs child assets may disqualify him or her from receiving means-based program benefits. However, setting up a supplemental-needs trust for your special-needs individual can help provide for their care without disqualifying him or her from SSI or Medicaid benefits.

Medicaid, SSI linked

Although the requirements should be reviewed periodically for changes, currently, to qualify for SSI benefits, a disabled adult cannot own more than $2,000 of assets. There is a link between eligibility for Medicaid and eligibility for SSI. Eligibility for SSI makes a disabled person eligible for food stamps and Medicaid, which pays medical expenses, nursing home care and mental health services. Given the very low poverty threshold, setting up a supplemental-needs trust can help provide for extra care over and above that which the government may provide.
All in all, a thoughtful piece and well worth reading the entire article. Even though slanted toward New Jersey residents, the info is relevant to all special-needs families in the U.S. The following is slanted toward Texas residents, but, again, good information for those in states with similar systems. From a Sept. 29 press release at Digital Journal:

DDS plays pivotal role in SSI/SSDI claims

Whether a Texan wants to make a claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the application process begins and ends with the Social Security Administration (SSA). However, after a Texan applies for benefits, their claim is forwarded to an intermediate governmental body. The Division for Disability Determination Services (DDS), part of the Texas Department of Assistive and Rehabilitative Services (DARS), makes disability determinations for all SSDI or SSI applicants in Texas. SSDI and SSI Benefits When Texans have physical or mental disabilities severe enough to hinder regular work activities, they can apply for federal SSA benefits to help restore a portion of lost income. The SSDI program covers disabled workers, and sometimes their family members, who have earned benefits by paying Social Security taxes during their employment.

DDS acts as SSA's agent

The SSI program considers an applicant's means and resources when determining coverage. Lower income adults and children typically qualify, but some people may be eligible for both programs. Application Process The application process, and how a person is determined as disabled, is the same in all U.S. states. Applicants fill out forms, either in person at a local Social Security office or online, providing information about their medical conditions, treatment and why working is difficult. They must also explain their work duties before the injury or disability and agree to release their medical records to the SSA and DDS. Once the Texas DDS receives the completed application, it can act as the SSA's agent to determine whether the applicant is disabled.
Again, lots of good info here, and well worth the time to study it and make notes so you can ask good questions when consulting with your disability attorney.