Guardianship and Advocacy

 Many parents of young adults with severe disabilities are surprised to learn that, after their child reaches adulthood (age 18), they are no longer the legal guardians.  Guardianship of minor children by their parents is a given, unless taken away by the court; guardianship of any adult must be granted by the court.

 Although a young adult who is severely disabled may remain in the family home, for all practical purposes the responsibility of proving incompetence falls to the parents.  This is true even in cases where most people would agree that the person is clearly incapable of self-direction.

 Persons without guardians are legally capable of making their own decisions.  The fact that parents are not legal guardians may not cause problems for the family in many circumstances; most adult service providers will naturally include family members in decision-making and planning in any case.  However, it is important to realize that, without legal guardianship, parents do not have a legal right to enforce their decisions about their adult child.

 Various Types of Guardianship:

• Guardianship: A guardian is a person who is legally charged with the responsibility of caring for or obtaining care for an individual, and managing the property and rights of that person.
• Conservatorship: A conservator is appointed through the courts to manage a citizen’s financial affairs.  A conservator is not allowed to make decisions about that citizen’s personal life.
• Power of Attorney: A power of attorney is a written document giving one person the power to act as an “agent” for another person.  To give Power of Attorney, you must be considered capable of understanding the document.
• Trust:  A trust gives a person or corporation (called the trustee) the right to manage or control property for the benefit of another person (called the beneficiary). A parent or guardian may set up a trust to help provide financial security in the future for a person with a disability.

 LEGAL ADVOCACY SERVICE

Legal Advocacy Service serves the people of Illinois through seven regional offices. For information contact: 1-866-274-8023

Sangamon County: Peoria Regional Office, 5407 North University, Suite 7, Peoria, Illinois 61614-4785, 309-693-5000, Fax 309-693-5050

Post High School Insurance Concerns

Insurance coverage after a student graduates from high school is an important issue for all families to address.  For the student with special needs this can be critical if not planned for and dealt with in the proper manner.  The State of Illinois Insurance Code (215 ILCS 5/356b) provides legal guidance for obtaining possible extended coverage of health insurance.  This statute allows parents to explore continued coverage for their young adult’s benefits under their family policy beyond the customary age limits.  To qualify under this act, the parent must notify their insurance carrier prior to their dependents reaching the standard age of termination.  Eligibility will be determined based on your insurance provider's: definition of disability and level of dependency.

 You may contact the Department of Insurance by calling or writing:

Illinois Department of Insurance, 320 W. Washington St., Springfield, Illinois 62767-001, Phone (217) 782-4515, Fax (217) 782-5020, TDD (217) 524-4872,  Web: www.ins.state.il.us

 

SAMPLE LETTER TO CONTACT FAMILY’S INSURER TO ESTABLISH ELIGIBILITY UNDER THIS STATUTE

Date Name of Insurance Company, Address City, State, ZIP   To Whom It May Concern:             This letter is being written to advise you that according to the Illinois Insurance Code (215 ILCS 5/356b), our son/daughter is legally qualified to receive extended coverage for medical benefits.  This statute allows (son’s/daughter’s name) to maintain his/her benefits under our family policy beyond the standard age limits.               This letter serves as our written notice to you regarding our intent to be included under the provision of Section 356b. Enclosed please refer to a copy of this statute and documentation of (son’s/daughter’s name) qualifying handicapping condition.   Yours truly, (insured’s signature) Policy # _______________________                Attn: Legal Dept.

Americans With Disabilities Act

(ADA)

 The purpose of the Americans with Disabilities Act of 1990 (ADA) is to bring those who have disabilities of one kind or another into mainstream American life. Disability is defined as “ physical or mental impairment that substantially limits one or more major life activities of such individual”. Major life activities are things that the average person can perform with little or no difficulty such as walking, seeing, hearing, learning or working, etc.  The ADA is broken down into four major areas or titles as follows:

 Title I – EMPLOYMENT

 Employers with 15 or more employees may not discriminate against qualified individuals with disabilities.  Employers must reasonably accommodate the disabilities of qualified applicants or employees, including modifying their workstation and equipment, unless undue hardship would result.

 Title II – PUBLIC SERVICES

 State and local governments may not discriminate against qualified individuals with disabilities.  Newly constructed state and local government building, including transit facilities must be accessible.  Alterations to existing state and local buildings must be done in an accessible manner.  Restrooms, drinking fountains, and telephones must be accessible as well.  All existing Amtrak stations must be accessible by July 26, 2000.  Complaints can be filed with the U.S. Dept. of Transportation.

 Title III – PUBLIC ACCOMODATIONS

 Privately operated businesses and not for profit facilities open to the public cannot discriminate against a customer on the basis of disability.  This includes restaurant, hotels, malls, museums, and other similar places.  Physical barriers in existing public accommodations must be removed.  If not, alternative methods of providing services must be offered.  Complaints may be filed with the U.S. Dept. of Justice.

 Title IV – TELECOMMUNICATIONS

 Telephone companies must provide telecommunications relay services 24 hours a day for individuals, who are deaf, hard of hearing and speech impaired.  TRS is a telephone service that allows people with hearing or speech disabilities to use the phone.  Complaints may be filed with the Federal Communications Commission.

Social Security Administration

 The Social Security Administration (SSA) manages two major programs that provide

cash benefits based on disability or blindness.

 SSDI-Social Security Disability Insurance (SSDI) provides benefits to disabled or blind individuals who are “insured” by workers’ contributions to the Social Security trust fund. These contributions are the Federal Insurance Contributions Act (FICA) Social Security tax paid on the earnings of their spouse or parents. Title II of the Social Security Act authorizes SSDI benefits.

 The worker must have worked and paid Social Security taxes for enough years to be covered under Social Security insurance; some of the taxes must have been paid in recent years.

 SSI- Most high school students have not worked enough quarters to be eligible for SSDI. The supplemental Security Income program (SSI) makes such cash assistance payments to aged, blind, and disabled people (including children under age 18) who have limited income and resources.

 For children under 18 years, the parent income and assets are included. If your child is over 18 years, then only his or her income and assets are included. Individuals must have countable resources below $2,000 to qualify for SSI (as of 1999).  Individuals, who are denied SSI before the age of 18, are encouraged to reapply once they reach age 18.

 Resource Limits for SSI

Individuals must have countable resources below $2,000 to qualify for SSI. Couples residing together must have countable resources below $3,000.

·        Social Security excludes many items in determining resource eligibility. Among items that are not counted are:

o       The individual’s home (so long as he or she resides in it),

o       Household goods and personal effects so long as their total equity value does not exceed $2,000

o       An automobile

·        Other criteria include:

o       Be a U.S. citizen or meet the requirements for non-citizens

o       Be considered medically disabled

Definition: (Disability for the Children’s SSI Program)

The welfare law defines children’s disability as follows:

• An individual under the age 18 shall be consider disabled for purposes of this title if that individual has a medically determinable physical or mental impairment which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; and
• Notwithstanding clause- no individual under the age of 18 who engages in substantial gainful activity may be considered disabled.

Application

A person can apply for Supplemental Security Income (SSI) benefits by calling the Social Security Administration’s toll-free number, 1-800-772-1213. A representative will schedule an appointment for an application to be taken over the phone or at any local Social Security Administration office. A person can also go to any local office and ask to file an application for disability benefits. Whichever way a person applies, he or she should KEEP COPIES of all documents and forms submitted to SSA. That way, if SSA loses information, a claimant can easily re-submit it.

 People who are deaf or hard hearing can call SSA’s toll-free TTY number, 1-800-325-0778. This number operates between 7 a.m. and 7 p.m.  Monday through Friday.

 A person who wants to apply for SSI Benefits for a child should take the following documents and information to the initial interview:

• Social security number for child and parents
• Birth certificate or other evidence of child’s date of birth
• Checking and savings account information
• Names, addresses and phone numbers of any doctors, hospitals, clinics, institutions, counselors that have treated child, as well as dates of any treatments
• Name of child’s school, list of teachers and counselors familiar with child’s condition, any school records, IEPs, psychological test results, reports cards, etc;
• List of current medications
• Any medical records, lab test or results, concerning child’s condition
• List of any employment claimant has held in the past 15 years (name and address of employer and type of work performed)
• Copy of W-2 form (wage and tax statement). Self- employed persons should bring a copy of their federal tax return for the past year
• Proof of income and assets payroll slips, bank books, insurance policies, car registration, burial fund records, and other information about income and assets
• Mortgage or lease agreements or other documents showing living arrangements

     SSA usually takes about 120 days to process applications for disability benefits. The local office collects information from the claimant. The file is sent to the Bureau of Disability Determination Services (BDDS) in Springfield, where an adjudicator is assigned to the case to collect medical evidence and reports from the claimant and others who may have information about the claimant’s medical condition. Doctors and nurses who contract with BDDS review the medical records and decide whether the claimant’s impairments fall within the SSI definition of disability.  The SSA local office sends a written decision to the claimant advising him or her that SSA has made a favorable or unfavorable decision.

 Often many initial applicants are denied SSI, and will want to submit an appeal. An appeal must be filed within 60 days. For further information on SSI and the appeal process, contact the local office at:

 Social Security Administration, 2715 W. Monroe St., Springfield, IL 62704, (217) 862-6651, TTY (217) 862-6681

  Social Security Internet Website, www.socialsecurity.gov

 

Other sources of information:

Social Security Coalition, (312) 223-9600, Web: www.ssic.org

Medicaid

There are several reasons why it is important to know about Medicaid. Once a student exits high school, turns 18 years old and is not attending college on a full-time basis, parents insurance may terminate. (Please see Post High School Insurance Concerns) If parent’s health insurance is not going to provide on going coverage, parents should explore Medicaid. This is a significant issue for students with medical needs to consider.

Operated by the Illinois Department of Public Aid, Medicaid is a form of medical insurance for the disabled, blind and aged. Eligibility includes:

        U.S. citizen or meet certain non-citizen requirements

   Live in Illinois

 In addition, applicants must meet the following criteria:

        All earned and unearned income as well as assets are reviewed when you apply for Medicaid because it is a needs based program. If you are over the limit but meet all other requirements, you may be placed in the Medicaid spend down program. Once a person is over 18 years old only his/her income is considered.

        Have proof of disability, blindness or age. If you are receiving SSI, this will be accepted as proof that you are blind, disabled, or aged. If you do not receive SSI then the Department of Human Services will evaluate your level of incapacity.

 The following are some examples of what Medicaid pays for:

 

• Hospital care           
• Doctor’s services
• Prescription drugs 
• Psychiatric care
• Renal dialysis
• Clinic Care

In addition, parents of significantly disabled students need to consider Medicaid to access:

• Supported Living Services. The developmentally disabled individual must have Medicaid prior to applying for S.L.S
• Psychosocial Rehabilitation/Day Treatment. Community mental health agencies have day programs for individuals with psychiatric disabilities who are not able to work.
• Residential Programs. Both developmentally disabled and psychiatric disabled for residential programs are required to have Medicaid.

These are just some examples of why Medicaid is important.

Resources:

• Division of Human Services (217) 782-0400
• General information 1-800-Medicare      
• www.cms.hhs.gov/medicaid