December 10, 2024 • 15 mins
What happens when a small oversight turns into a $6,850 lesson? Join me, Todd Whatley, on a journey through the complexities of elder law, as I recount an unforgettable personal story that underscores the critical importance of communication and documentation in the Medicaid application process. This episode isn't just about a mistake; it's about embracing errors as stepping stones to improvement and growth. Learn how the Community Spouse Resource Allowance (CSRA) plays a vital role, and why removing an institutionalized spouse's name from assets exceeding $2,000 is a non-negotiable step in elder law practice. By sharing this open and honest account, I aim to empower fellow attorneys to recognize that even seasoned professionals stumble, and that the true value lies in the lessons we extract from these experiences.
To prevent future missteps, I discuss the transformative power of office checklists, designed to ensure every detail is accounted for, much like the protocols that keep airline operations running smoothly. Hear how these structured processes can maintain client trust and uphold a law firm’s reputation. Additionally, I introduce an exclusive coaching program crafted to elevate your elder law practice, particularly for those eager to master crisis Medicaid cases swiftly. This program promises to guide you from your initial client interaction to the final resolution, equipping you with the expertise needed to thrive. Subscribe now to gain more invaluable insights, and visit our website for resources that can help make you an elder law authority.
Check out our new website www.TheElderLawCoach.com.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:19):
Thank you.
Specialized experience, Whetheryou're an established attorney
looking to refine your expertiseor an emerging lawyer seeking a
successful foray into elder law, this is your masterclass.
Now let's get started with theluminary in the field.
Here's Todd Whatley.
Speaker 2 (00:37):
That's right.
This is the Elder Law Coach.
My name is Todd Whatley, I amthe Elder Law Coach and I
appreciate you listening, asalways, and if you haven't
subscribed, please subscribe sothat you'll get immediate notice
when we post a new podcast.
And one of my New Year'sresolutions is to be much more
(00:58):
consistent with this.
Be saying it in the past, butI'm putting some things in place
in my office so that it willfree up some time for me to be
able to do more of these and tobe able to get more information
out there.
So today I am a little cranky,aggravated with myself, with
(01:21):
staff, with the process, and Iwant to share that with you
because, as you know me, my jobis to make all the mistakes for
you so that you don't have to.
So let me just kind of back upa little bit and the reason I do
this, the reason I come ontothis platform and say, yep, we
messed up.
I messed up A very expensivemess up and, as you can tell by
(01:44):
the title of this podcast, itwas a $6,850 problem mistake, a
letter that was not sent out asit should have cost me $6,850.
So I tell you these thingsbecause I have never worked in a
(02:07):
big firm, I've always workedfor myself, and so when I was
figuring this out and if anyoneknows my story, you know when I
started doing this, I did itabsolutely by myself.
There was no one locally tohelp me.
The only elder law attorney wasnot sharing information.
There was not anyone like me,an elder law coach, that I could
(02:29):
call and get advice from.
I figured this out myself, andwhen I would make mistakes, I'm
like I'm probably the onlyperson who's ever made that
mistake and I would just feelterrible about myself and think,
oh my God, I'm terrible at this, you know, I'm the only one
who's ever done this.
And I think, oh my God, I'mterrible at this, you know, I'm
the only one who's ever donethis.
And so, as I got into it andbecame much more confident, I
(02:49):
was willing to share mistakesand problems with other people.
And they're like yep, done that.
And just by hearing people talkover dinner they don't ever say
this from this stage whenthey're presenting, but going to
conferences and things havingdinner with people and they're
like man, I got a one-starreview this week, or man, I just
(03:10):
had to write a check because,blah, blah, you know I messed
this up or whatever, and I waslike, okay, so I'm not the only
one who's ever messed up.
So I want to share this with youso that you understand yeah,
some people that have been doingthis a really long time mess up
, and no one's perfect, and so Iencourage you to share with me,
(03:33):
call me and say, hey, man, Imessed up.
Can you help me through thisone little bit?
I would be glad to because,trust me, I've been there, done
that.
I won't think bad of you.
Hey, you're just part of us.
Okay, if you've never made amistake, I would wonder what
you're doing.
You're not trying very hard oryou're not putting much out
there, but we've all mademistakes, and so I wanted to
(03:55):
bring this up today and this wasa very good teaching point that
we all learned in my office andI wanted to share with you.
So why $6,850?
You probably know, and if youdon't, I want to teach you on
(04:17):
this specific point.
But the whole purpose of today'spodcast is not to teach you
just this one specific Medicaidpoint.
It's a general practice tip,okay, but specifically, if you
do Medicaid, when you get amarried person onto Medicaid,
you understand that the amountthat they have to get down to is
half of the snapshot amount,are the maximum community spouse
(04:42):
resource allowance, csra, allright.
So whatever that number is, thecommunity spouse gets to keep
and then no more than $2,000 orwhatever your state's number is
for the institutionalized spouse.
So there's the community spousemoney and then the
institutionalized spouse's money, and those are on paper.
(05:03):
They're not specifically inbank accounts.
I mean, you don't have to getthe InstaTouchline spouse all
the way under $2,000 for theapplication and the snapshot
date.
But almost every state thatI've looked at, within a year
from qualification you do haveto get the InstaTouchline
(05:24):
spouse's name off of anythingover $2,000.
And so generally we get theirname on one bank account where
his Social Security goes intoand that's it.
Okay.
His name's off the IRAs,everything else, and you don't
have to do it immediately at thetime of application.
But you can do it within a yearbecause at the one year
(05:46):
re-evaluation they're going tocome back and see what does he
have his name on and if it'smore than $2,000, even if it is
within the CSRA, his name is onit.
It's over $2,000.
You're disqualified, okay.
So that's the rule.
We have a letter that says that,and toward the end of this I'll
(06:07):
talk about things to do toprevent this in general, but I
am almost positive.
We send out a letter initiallysaying hey, you're married,
you're applying for Medicaid,here's some things you need to
be aware of, and it's a longletter, it's got a bunch of
stuff, and I do that mainly tocover myself and to let them see
(06:29):
here's the process.
But you can expect them toremember all of that and get it
all correct, particularly at thefront end, when you're dealing
with stuff.
Almost a year later, I do knowthat we have a final letter that
goes out once we have gottenthis person qualified for
(06:49):
Medicaid.
I know that we send out aletter that says congratulations
, you're qualified, here's somethings you need to be aware of.
And one of those things that weput in there to make sure the
person is aware of is this issuewith the institutionalized
spouse cannot have their name onmore than $2,000.
(07:12):
Okay, and so therefore, it's ina letter, we say it and it's
there and it's covered, and ittells people, or at least we can
point back to this letter andsay we told you this and we try
to bring it up verbally, but atleast we have it in writing and
(07:34):
we know that we gave it to them.
Well, in this one case, myMedicaid person and if you know
my office very well, it's Sarah.
She's done a fantastic job withme.
I'm not mad at her Thingshappen okay.
But it was a letter that did notgo out and sure enough she did
not get her dad's name off ofthis account and sure enough she
(07:55):
did not get her dad's name offof this account.
And so when Medicaid found thatthey came back with two months
of disqualification Now for somereason I was able to get one
month fixed, but the other monthI could not get fixed and it
was, you know, after his incomepaid, what he always had to pay.
(08:18):
The difference was $6,850.
And I tried to put it off.
I tried to get DHS to approvethat month and they just
wouldn't.
And so finally the client camein and I just admitted I was
like we have a letter and Ican't prove that we've sent it
to you, and she said I never gotthat letter.
I said I know, and because wedid not tell her to do that, she
(08:43):
did not know to fix it and Ithought the only ethical thing
to do was to reimburse her forthat month that she had to pay
because we did not tell her toget his name off of that account
.
Now you may see that as beingjust overly generous and it's
like, oh, I would have foughtthat.
I've never had a client file aclaim on my malpractice
(09:07):
insurance because I take care ofit.
And just if I had a major youknow many tens of thousands or
$100,000 claim or whatever, sureI would put that on my
insurance.
But for small amounts you knowthat the insurance company is
going to fight them and it'sgoing to be delayed and they're
(09:28):
going to have to hire anattorney and an attorney is
going to take a third of thesettlement.
And it's just it's not in thebest interest of the client or
their family settlement, andit's just it's not in the best
interest of the client or theirfamily.
And so, therefore, I havealways stepped up to the plate,
paid the damage and just movedon, and I think I have a good
(09:53):
reputation for doing that andpeople appreciate that and I
sleep really well at night.
Okay, you may do it differently,but that's how I do it not.
Okay, you may do it differently, but that's how I do it.
So how can we prevent that?
Well, we have implementedchecklist, so there's a we have,
obviously, a checklist of items.
We need to start theapplication Now.
We are doing a checklist to endthe application.
(10:14):
Once they're approved, onceeverything's done, there's a
checklist of things.
Did you do this, did you do this, did you do this?
And I don't have that in frontof me because that's not the
purpose of this podcastno-transcript, relying from
(10:38):
memory.
And one thing I don't like tothink about this but what if
your assistant was killed in acar wreck?
There was no way they could say, hey, I'm going to be gone from
now on.
Here's some things y'all needto look at.
What if, boom, instantly gone?
How would you know what to dofor that person?
How would someone stepping intothat person's role be able to
(11:01):
do their job?
If you have checklists in placeand procedures and policies in
place, it's very simple foranother person to step into that
role, pick up and carry onexactly as they were doing.
Okay, and so that's one thing Ihonestly did not do in my office
, and it's one thing we are nowimplementing is checklists of
(11:23):
things at the end of theapplication to make sure the
client knows this, that we havetold them this and we have proof
that we've sent the letter orhad the conversation with them.
And so it is so important to doto get documents in place,
checklists, letters.
You know closing things,closing letters to make sure
(11:46):
things are taken care of anddone Okay.
So I encourage you, learn frommy mistakes.
I hope you never have to writea very big check to a client
because your office messed up.
Learn from my mistake.
Learn from this 6850 whoopsthat you need to do a checklist,
(12:09):
you need to make sure theclient knows this and that your
staff knows exactly what to do.
But take this as an opportunityto grow and say, hey, we're
going to have lots of systemsand procedures in place with
checklists, and you think, ohman, checklists.
Think about this A pilot, acommercial airline pilot, who
(12:31):
flies all day, every day.
I mean, I know they don't workevery day, but when they work
they typically take a lot offlights.
They do this all the time.
You would think taking off andlanding would be just what they
do, but they have checklists.
There are checklists that theydo every single flight.
Okay, even though they just didit 30 minutes ago.
(12:54):
They're doing it again.
They have a checklist and theygo through it.
And so, particularly thosethings that you do repeatedly
that are always the same, alwaysthere, have a checklist, make
your staff go through it, have achecklist for this client it's
got their name at the top of itand you go through it and once
you check it off with dates orproof or whatever it's there,
(13:19):
you've done it.
It's part of the client's fileso that you can go back to it
and say, yep, we did thechecklist, it's done.
All right.
Okay, I feel better now.
I feel better that, yes, thiscost me $6,850, but hopefully I
can share with you and I canhelp you not make that mistake
(13:39):
and I'll know that I'vehopefully helped someone out
there.
Do better.
Do better than me, okay, andnot make this mistake again and
do good for your clients andkeep as much money as you can
and not have to pay it out inuh-oh fees.
All right, I hope this washelpful.
(14:00):
If so, please let me know.
Todd, at the elderlawcoachcom,just say hey, Todd, appreciate
the podcast.
Yes, I've made that mistake.
Thank you for telling us, or Iwas about to make that mistake
and your podcast kept me from it.
That would just absolutely makemy day.
So I would love to hearfeedback from you.
Todd, at the elderlawcoachcom,please email me and, as always,
(14:23):
if you want to get into elderlaw and do it really well and do
it quickly and not turn awaythose clients that you've been
turning away for crisis Medicaid, take it, get the information,
call me, let's go through it,let's get you into coaching and
I will walk you all the waythrough this, from the very
first meeting all the waythrough the end.
(14:43):
Okay, give me a call.
Appreciate you listening.
Please subscribe and I will seeyou next time.
Speaker 1 (14:50):
Thank you for joining this episode of the Elder Law
Coach Podcast.
For those eager to take theirelder law practice to new
heights and are interested inTodd's acclaimed coaching
program, visitwwwtheelderlawcoachcom.
With Todd Whatley by your side,the journey to becoming an
elder law authority has neverbeen more achievable.
(15:10):
Until next time, keep learning,keep growing and stay
passionate about elder law.
Thank you.
Specialized experience, Whetheryou're an established attorney
looking to refine your expertiseor an emerging lawyer seeking a
successful foray into elder law, this is your masterclass.
Now let's get started with theluminary in the field.
Here's Todd Whatley.
Speaker 2 (00:37):
That's right.
This is the Elder Law Coach.
My name is Todd Whatley, I amthe Elder Law Coach and I
appreciate you listening, asalways, and if you haven't
subscribed, please subscribe sothat you'll get immediate notice
when we post a new podcast.
And one of my New Year'sresolutions is to be much more
(00:58):
consistent with this.
Be saying it in the past, butI'm putting some things in place
in my office so that it willfree up some time for me to be
able to do more of these and tobe able to get more information
out there.
So today I am a little cranky,aggravated with myself, with
(01:21):
staff, with the process, and Iwant to share that with you
because, as you know me, my jobis to make all the mistakes for
you so that you don't have to.
So let me just kind of back upa little bit and the reason I do
this, the reason I come ontothis platform and say, yep, we
messed up.
I messed up A very expensivemess up and, as you can tell by
(01:44):
the title of this podcast, itwas a $6,850 problem mistake, a
letter that was not sent out asit should have cost me $6,850.
So I tell you these thingsbecause I have never worked in a
(02:07):
big firm, I've always workedfor myself, and so when I was
figuring this out and if anyoneknows my story, you know when I
started doing this, I did itabsolutely by myself.
There was no one locally tohelp me.
The only elder law attorney wasnot sharing information.
There was not anyone like me,an elder law coach, that I could
(02:29):
call and get advice from.
I figured this out myself, andwhen I would make mistakes, I'm
like I'm probably the onlyperson who's ever made that
mistake and I would just feelterrible about myself and think,
oh my God, I'm terrible at this, you know, I'm the only one
who's ever done this.
And I think, oh my God, I'mterrible at this, you know, I'm
the only one who's ever donethis.
And so, as I got into it andbecame much more confident, I
(02:49):
was willing to share mistakesand problems with other people.
And they're like yep, done that.
And just by hearing people talkover dinner they don't ever say
this from this stage whenthey're presenting, but going to
conferences and things havingdinner with people and they're
like man, I got a one-starreview this week, or man, I just
(03:10):
had to write a check because,blah, blah, you know I messed
this up or whatever, and I waslike, okay, so I'm not the only
one who's ever messed up.
So I want to share this with youso that you understand yeah,
some people that have been doingthis a really long time mess up
, and no one's perfect, and so Iencourage you to share with me,
(03:33):
call me and say, hey, man, Imessed up.
Can you help me through thisone little bit?
I would be glad to because,trust me, I've been there, done
that.
I won't think bad of you.
Hey, you're just part of us.
Okay, if you've never made amistake, I would wonder what
you're doing.
You're not trying very hard oryou're not putting much out
there, but we've all mademistakes, and so I wanted to
(03:55):
bring this up today and this wasa very good teaching point that
we all learned in my office andI wanted to share with you.
So why $6,850?
You probably know, and if youdon't, I want to teach you on
(04:17):
this specific point.
But the whole purpose of today'spodcast is not to teach you
just this one specific Medicaidpoint.
It's a general practice tip,okay, but specifically, if you
do Medicaid, when you get amarried person onto Medicaid,
you understand that the amountthat they have to get down to is
half of the snapshot amount,are the maximum community spouse
(04:42):
resource allowance, csra, allright.
So whatever that number is, thecommunity spouse gets to keep
and then no more than $2,000 orwhatever your state's number is
for the institutionalized spouse.
So there's the community spousemoney and then the
institutionalized spouse's money, and those are on paper.
(05:03):
They're not specifically inbank accounts.
I mean, you don't have to getthe InstaTouchline spouse all
the way under $2,000 for theapplication and the snapshot
date.
But almost every state thatI've looked at, within a year
from qualification you do haveto get the InstaTouchline
(05:24):
spouse's name off of anythingover $2,000.
And so generally we get theirname on one bank account where
his Social Security goes intoand that's it.
Okay.
His name's off the IRAs,everything else, and you don't
have to do it immediately at thetime of application.
But you can do it within a yearbecause at the one year
(05:46):
re-evaluation they're going tocome back and see what does he
have his name on and if it'smore than $2,000, even if it is
within the CSRA, his name is onit.
It's over $2,000.
You're disqualified, okay.
So that's the rule.
We have a letter that says that,and toward the end of this I'll
(06:07):
talk about things to do toprevent this in general, but I
am almost positive.
We send out a letter initiallysaying hey, you're married,
you're applying for Medicaid,here's some things you need to
be aware of, and it's a longletter, it's got a bunch of
stuff, and I do that mainly tocover myself and to let them see
(06:29):
here's the process.
But you can expect them toremember all of that and get it
all correct, particularly at thefront end, when you're dealing
with stuff.
Almost a year later, I do knowthat we have a final letter that
goes out once we have gottenthis person qualified for
(06:49):
Medicaid.
I know that we send out aletter that says congratulations
, you're qualified, here's somethings you need to be aware of.
And one of those things that weput in there to make sure the
person is aware of is this issuewith the institutionalized
spouse cannot have their name onmore than $2,000.
(07:12):
Okay, and so therefore, it's ina letter, we say it and it's
there and it's covered, and ittells people, or at least we can
point back to this letter andsay we told you this and we try
to bring it up verbally, but atleast we have it in writing and
(07:34):
we know that we gave it to them.
Well, in this one case, myMedicaid person and if you know
my office very well, it's Sarah.
She's done a fantastic job withme.
I'm not mad at her Thingshappen okay.
But it was a letter that did notgo out and sure enough she did
not get her dad's name off ofthis account and sure enough she
(07:55):
did not get her dad's name offof this account.
And so when Medicaid found thatthey came back with two months
of disqualification Now for somereason I was able to get one
month fixed, but the other monthI could not get fixed and it
was, you know, after his incomepaid, what he always had to pay.
(08:18):
The difference was $6,850.
And I tried to put it off.
I tried to get DHS to approvethat month and they just
wouldn't.
And so finally the client camein and I just admitted I was
like we have a letter and Ican't prove that we've sent it
to you, and she said I never gotthat letter.
I said I know, and because wedid not tell her to do that, she
(08:43):
did not know to fix it and Ithought the only ethical thing
to do was to reimburse her forthat month that she had to pay
because we did not tell her toget his name off of that account
.
Now you may see that as beingjust overly generous and it's
like, oh, I would have foughtthat.
I've never had a client file aclaim on my malpractice
(09:07):
insurance because I take care ofit.
And just if I had a major youknow many tens of thousands or
$100,000 claim or whatever, sureI would put that on my
insurance.
But for small amounts you knowthat the insurance company is
going to fight them and it'sgoing to be delayed and they're
(09:28):
going to have to hire anattorney and an attorney is
going to take a third of thesettlement.
And it's just it's not in thebest interest of the client or
their family settlement, andit's just it's not in the best
interest of the client or theirfamily.
And so, therefore, I havealways stepped up to the plate,
paid the damage and just movedon, and I think I have a good
(09:53):
reputation for doing that andpeople appreciate that and I
sleep really well at night.
Okay, you may do it differently,but that's how I do it not.
Okay, you may do it differently, but that's how I do it.
So how can we prevent that?
Well, we have implementedchecklist, so there's a we have,
obviously, a checklist of items.
We need to start theapplication Now.
We are doing a checklist to endthe application.
(10:14):
Once they're approved, onceeverything's done, there's a
checklist of things.
Did you do this, did you do this, did you do this?
And I don't have that in frontof me because that's not the
purpose of this podcastno-transcript, relying from
(10:38):
memory.
And one thing I don't like tothink about this but what if
your assistant was killed in acar wreck?
There was no way they could say, hey, I'm going to be gone from
now on.
Here's some things y'all needto look at.
What if, boom, instantly gone?
How would you know what to dofor that person?
How would someone stepping intothat person's role be able to
(11:01):
do their job?
If you have checklists in placeand procedures and policies in
place, it's very simple foranother person to step into that
role, pick up and carry onexactly as they were doing.
Okay, and so that's one thing Ihonestly did not do in my office
, and it's one thing we are nowimplementing is checklists of
(11:23):
things at the end of theapplication to make sure the
client knows this, that we havetold them this and we have proof
that we've sent the letter orhad the conversation with them.
And so it is so important to doto get documents in place,
checklists, letters.
You know closing things,closing letters to make sure
(11:46):
things are taken care of anddone Okay.
So I encourage you, learn frommy mistakes.
I hope you never have to writea very big check to a client
because your office messed up.
Learn from my mistake.
Learn from this 6850 whoopsthat you need to do a checklist,
(12:09):
you need to make sure theclient knows this and that your
staff knows exactly what to do.
But take this as an opportunityto grow and say, hey, we're
going to have lots of systemsand procedures in place with
checklists, and you think, ohman, checklists.
Think about this A pilot, acommercial airline pilot, who
(12:31):
flies all day, every day.
I mean, I know they don't workevery day, but when they work
they typically take a lot offlights.
They do this all the time.
You would think taking off andlanding would be just what they
do, but they have checklists.
There are checklists that theydo every single flight.
Okay, even though they just didit 30 minutes ago.
(12:54):
They're doing it again.
They have a checklist and theygo through it.
And so, particularly thosethings that you do repeatedly
that are always the same, alwaysthere, have a checklist, make
your staff go through it, have achecklist for this client it's
got their name at the top of itand you go through it and once
you check it off with dates orproof or whatever it's there,
(13:19):
you've done it.
It's part of the client's fileso that you can go back to it
and say, yep, we did thechecklist, it's done.
All right.
Okay, I feel better now.
I feel better that, yes, thiscost me $6,850, but hopefully I
can share with you and I canhelp you not make that mistake
(13:39):
and I'll know that I'vehopefully helped someone out
there.
Do better.
Do better than me, okay, andnot make this mistake again and
do good for your clients andkeep as much money as you can
and not have to pay it out inuh-oh fees.
All right, I hope this washelpful.
(14:00):
If so, please let me know.
Todd, at the elderlawcoachcom,just say hey, Todd, appreciate
the podcast.
Yes, I've made that mistake.
Thank you for telling us, or Iwas about to make that mistake
and your podcast kept me from it.
That would just absolutely makemy day.
So I would love to hearfeedback from you.
Todd, at the elderlawcoachcom,please email me and, as always,
(14:23):
if you want to get into elderlaw and do it really well and do
it quickly and not turn awaythose clients that you've been
turning away for crisis Medicaid, take it, get the information,
call me, let's go through it,let's get you into coaching and
I will walk you all the waythrough this, from the very
first meeting all the waythrough the end.
(14:43):
Okay, give me a call.
Appreciate you listening.
Please subscribe and I will seeyou next time.
Speaker 1 (14:50):
Thank you for joining this episode of the Elder Law
Coach Podcast.
For those eager to take theirelder law practice to new
heights and are interested inTodd's acclaimed coaching
program, visitwwwtheelderlawcoachcom.
With Todd Whatley by your side,the journey to becoming an
elder law authority has neverbeen more achievable.
(15:10):
Until next time, keep learning,keep growing and stay
passionate about elder law.
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