The Supreme Court decision on the Affordable Care Act (ObamaCare) has tremendous implications for our practice, primarily negative, but is a huge boon to planning for persons with disabilities who have been shut out of the private insurance market in the past.  Our law firm’s loss is our clients’ gains, and we couldn’t be happier

We’re working on an appeal of another attorney’s client’s case that was lost at a Social Security Adminsitration Administrative Law Judge hearing.  In reviewing the twelve page decision, we find the judge wrote the following (the typos are ALL his):

"Rather, when examined by Dr. Miguel xxxx, a psychiatrist at the request of the office of

The South Dakota Supreme Court decision attached actually pre-dates the U.S. Circuit Court of Appeals decision yesterday by a couple of weeks, but comes to the same conclusion, and further adds language that no state may avoid application of the federal rule:

“[¶ 44.] In a CMS memorandum from Gale P. Arden, Director of Disabled

When a person on SSI and Medicaid concludes a lawsuit for personal injuries, the Florida Medicaid agency swoops in and takes a big bite of the settlement or jury verdict to reimburse itself for the doctor and hospital bills caused by the person or corporation that hurt the disabled SSI/Medicaid recipient.  This action is based on the Florida Medicaid Third Party Liability Act, Florida Statutes, Section 409.910.

A few years ago, the U. S. Supreme Court substantially and appropriately reduced what Medicaid can get.  Click here for the Alhborn case.  Florida Medicaid has resisted the Supreme Court’s decision, but its position is now substantially weakened by a new U. S. Circuit Court of Appeals decision.

Based on a March 22nd U. S. Circuit Court of Appeals decision, more net settlement money is going to go to diasbled plaintiffs.  The court’s decision completely eviscerates the Florida Medicaid agency’s defense to avoiding the reduction in the Medicaid lien based on the U.S. Supreme Court Ahlborn decision in 2006. This is going to allow substantially MORE money to go into plaintiff’s Special Needs Trusts funded from  Personal Injury/Medical Malpractice settlements or jury verdicts.


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It would be difficult to underestimate the positive impact of ObamaCare – the Affordable Care Act – on persons with disabilities.  In the last two weeks, I have had three clients who were seeking a finding of "disabled" by the Social Security Administration because being found eligible for a monthly disability check would qualify them to receive health care.  None of them are now that they can purchase health insurance.

The private profit-making health insurance industry will not take individuals with pre-existing health conditions.  One client, a published author, had lost her health insurance when she developed Crohn’s Disease.  Although it was initially somewhat managed, painfully, by medications, she now needs to have many feet of necrotic intestinal tissue removed surgically from her stomach.  Even though she has money, no insurance company would sell her health insurance.  She has too much money for Medicaid eligibility.  She will die without surgery.


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Each year the Social Security Administration announces in October if there will be any changes in the amount of payments of SSI and SSDI due to Cost of Living Adjustments.  The new payments for SSI for 2012 are $698 to and individual, and $1048 to a married couple who are both on SSI.  SSI is

Congratulations and a  big thank you to our Florida Congressmen, Ander Crenshaw and Kendrick Meek, who have introduced legislation to allow families to plan for their loved ones with some significant tax saings.   Information on the bill follows.  To see the bill in its entirety, click on H.R. 1205.

Disability Savings Accounts

The bipartisan Achieving

The Social Security Administration (SSA)  has provided attorneys and the general public with very useful information on their analysis of Special Needs Trusts – are you eligible or ineligible if you have such a trust.  There are a lot of ways that attorneys can inadvertently cause a Special Needs Trust to be found in violation