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Important Healthcare Legal Tips &
Anthem Hacking Alert

Healthcare matters can involve a whole host of medical and legal complications. At best, these issues may affect you financially; at worst, they could mean the difference between life and death. Whether you go to the hospital for a routine procedure or an emergency, there are steps you can take to help avoid complications. If you have any legal questions, call your LegalShield provider law firm and speak with an attorney right away.

  • Have an up-to-date Medical Power of Attorney or Advanced Medical Directive (“Living Will”). In the event you cannot make medical decisions yourself, these documents entrust decisions about your care to a person you designate. Advise your family of your designation so that person is notified when decisions must be made.
     
  • Make sure your name, identifying information and all other information is completely accurate at each doctor’s appointment, outpatient surgery and hospitalization. Serious problems involving medical care sometimes begin as simple clerical errors. A small error can create a major treatment crisis. Reduce the chance of error by carefully reviewing all of your doctor’s office or hospital admissions paperwork. During hospitalization check your hospital wristband for errors.
     
  • Understand your health insurance coverage before you get sick. It is important that you understand all of the limitations and exclusions in your insurance policy. Your policy may require you to obtain preauthorization for medical procedures. In addition, you may need supplemental coverage or disability coverage in the event of a long recovery. Review your health coverage now. It is too late to make critical changes after you get sick.
     
  • Save any documents you receive regarding your care or billing. Retain all of your medical documentation in the event of a fee dispute, insurance dispute or medical malpractice claim. Documents can be easily misplaced in the confusion of care and recovery. If you are too ill to organize your own paperwork ask someone you trust to help manage your documentation.
     
  • Ask for a second opinion if you are unsure about your diagnosis or treatment. You always have the right to speak with another doctor or caregiver if you are uncomfortable with the diagnosis or treatment recommendations being made.
     
  • Advocate for quality care. It is important to speak up for yourself in healthcare situations. If you or a loved one have been hospitalized and have concerns about the quality of care, speak to a doctor or nursing supervisor. If you are unable to advocate for yourself due to the nature of your illness, medications or treatments, have a friend or family member stay with you. Many hospitals have a designated advocate on staff. If you feel your concerns are not addressed ask to speak with a patient advocate.
     

Anthem Hacking Alert

Criminal hackers recently stole confidential data of millions of persons insured by Anthem Blue Cross Blue Shield. If you are insured by Anthem we urge you to CLICK HERE to go to Anthem's website for important information about the breach and what you should do to protect yourself.

Anthem states they will individually notify those whose information was accessed. However, if you are insured by one of the Anthem plans you need to be aware of the following now:

You have the right by federal law to place fraud alerts with the three national credit reporting agencies (CRAs). This will place a statement on your credit reports to alert credit issuers that you may be vulnerable to identity theft and that they should take reasonable steps to verify that the person applying for credit is actually you.

Place an alert with all three CRAs by calling just one:

Equifax: 888-766-0008   |   Experian: 888-397-3742   |  TransUnion: 800-680-7289

Scammers may try to use this event to trick people into giving up personal information. If you receive an email or phone call from someone claiming to be from Anthem and asking for your personal information, do not respond to them. Call Anthem directly at 1-877-263-7995 to determine if it was their actual representative who contacted you.

Carefully review your LegalShield Identity Theft Plan Alerts. If you receive an alert from your Identity Theft Plan and do not recognize the activity as something you authorized, please call 888-494-8519 to speak to an Investigator.

1229

7 CRITICAL Elder Care Legal Tips

It is vital to begin planning for long-term elder care well before the onset of a health crisis. There are many things to consider, including quality of care, proximity to family and friends, types of service and cost. With careful planning and the help of your LegalShield provider law firm you may be able to avoid some of the common challenges associated with the transition to nursing home care.

Plan Early – Nursing home care can cost $200 or more per day. Many seniors simply do not have the financial means to cover that cost. Planning early allows you to protect your assets and help ensure that you qualify for assistance. Call your LegalShield provider law firm and speak with an attorney early in the process.

Care Options – There are many types of care, including home health aids, adult day care, assisted living, nursing homes and hospice. Understand the requirements, cost and feasibility of each type of care available to you. What can you afford? What will your insurance, Medicare or Medicaid cover?

Talk to Your Family – Make sure your family and any other individuals who may be responsible for your long-term care understand your wishes. Prepare a medical power of attorney so the friend or family member you appoint is empowered to make medical decisions on your behalf should you be unable to do so.

Medicaid - Medicaid is a state program that is reimbursed by the U.S. federal government. Different states provide different levels of care for different individuals. If you become dependent on Medicaid to pay for long-term care, here are some important facts you should know:

To qualify for Medicaid, you must be below asset and income thresholds. Otherwise, you will have to self-pay or engage in some sort of "spend-down" of your assets until you qualify for Medicaid.
If Medicaid pays for your long-term care, after you pass away (with few exceptions) Medicaid will assert what is called "Medicaid Estate Recovery" against your estate to recoup what is paid. This means that assets that you thought were going to pass to your family will be taken to repay Medicaid for amounts spent on your long-term care.
If you simply try to "give away" your assets prior to going into a nursing home, you could actually be disqualifying yourself from receiving Medicaid long-term care benefits and you may have other problems such as state gift tax liability (depending on your state of residence).
 

Assistance for Canadians - In Canada, if you don’t have the resources to fund the costs of your long-term care, you can apply to the province for a reduction; however, you are required to apply for all available government funding such as Canada Pension and Old Age Security. (Unlike the United States, there is no recovery of assets after your death for government funding paid on your behalf.)

Contracts – Make sure you have your LegalShield provider law firm carefully review any nursing home contracts or agreements before you sign them. It is important that you and your family understand the full terms of any agreement you make with a nursing home or other facility.

Closely Monitor Care – It is important to monitor family members and friends in long-term care. Set up a schedule to ensure frequent visits from friends and family. Ask questions about any injuries and follow up with doctors and nursing staff on their plan of action. If your friend or family member is receiving in-home care make sure you know the name of the caretaker and their agency. Make sure the agency is properly licensed and insured.
 

 

 

 

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Take Control of Your Important
Health Care Decisions

Do you want life support if you become totally and permanently incapacitated? Who do you want making health care decisions on your behalf if you are unable to do so? A living will and health care power of attorney will help answer those questions, but it is important to have those documents prepared before the onset of a health crisis. The laws and even the names of certain legal forms may vary by state or province. Contact your LegalShield provider law firm to learn more about the laws where you live and how to best protect your wishes.

A living will, sometimes known as a health care declaration or advance directive, is a legal document that allows you to specify in writing the kinds of life-sustaining treatments you are or are not willing to receive should you become incapacitated. Specific treatments may include feeding tubes, dialysis, resuscitation or breathing machines.

It is impossible to foresee every possible medical challenge you may face. A health care power of attorney allows you to appoint an agent or proxy to make medical decisions on your behalf. Unlike a general durable power of attorney, a health care power of attorney is limited to medical decisions only. It is important to pick someone who is comfortable with his or her role as your proxy and understands your wishes. It is also important to pick an alternate agent in the event your primary agent is unable to serve.

The laws where you live will determine which forms will best protect your wishes. It is always important to discuss your wishes with your family and your health care providers. Many doctors’ offices and hospitals now require patients to complete a living will or health care POA. If you need assistance or have any questions contact your LegalShield provider law firm today.

 

 

What You Need to Know About Divorce

Reasons for divorce differ widely and, while couples and their children may be better off after a divorce than before, the unfortunate fact is that all parties lose something. Divorce can be emotionally and financially devastating for everyone involved. It is important to understand some important legal issues that arise during a divorce. If you are considering divorce or have any questions call your LegalShield provider law firm and speak with an attorney.

Early Intervention – Starting divorce counseling early in the process may help couples, particularly those with children, create an atmosphere in the divorce that will minimize anger and enmity. Mediation and counseling also help improve communication between the couple and lead to more amicable and less costly divorce proceedings.

“No Fault” Divorce – A “no fault” divorce means that neither party is considered at fault for the dissolution of the marriage. State or provincial requirements may vary. Some laws may require the parties to live separate and apart for a period of months before the divorce is granted. This period may be extended if there are minor children of the marriage. Talk to your LegalShield provider about the laws where you live.

Uncontested Divorce – In an uncontested divorce the parties are able to agree on the distribution of property, terms of support and custody without court intervention. Agreeing to divorce does not mean a divorce is uncontested; there must be complete agreement on all of the divorce settlement terms. Uncontested divorces are less costly and may benefit both parties. It is still important to speak with an attorney, even in cases of uncontested divorce, to understand the laws in the jurisdiction where the divorce will be filed and because circumstances may change if a dispute arises while negotiating the settlement. In addition, a judge must approve the agreement. Approval is not guaranteed simply because the spouses agree on child custody, visitation and other terms. If the judge does not approve the matter may become a contested divorce.

Contested Divorce – Contested divorces are those where there are disputes over spousal support, child support, property distribution, child custody or visitation. Most attorneys require minimum retainers of at least $4,000 and sometimes up to $10,000 to begin a contested divorce. Attorneys may also charge rates exceeding $250 per hour. Early mediation can help reduce or eliminate the contested issues, significantly reducing the final cost of the divorce. More conflict in a divorce will result in a higher cost for everyone involved.

Discovery – Contested divorces in which spousal or child support or distribution of property is contested will often include extensive discovery of all of the financial, insurance, retirement funds, investment funds, real estate, car titles and employment records of each party for several years prior to the filing of the divorce. The time and expense associated with discovery will drastically increase the cost of your divorce.

Punishment – Divorce proceedings are intended only to dissolve the marriage, distribute property and provide for the best interests of the children. Courts will not use the proceeding to “punish” a spouse. Discuss your legal options with your attorney to make sure your decisions are based on legal merit rather than anger and frustration.

Unpredictable Outcomes – Some states do not have a set formula for spousal support or property division in a contested divorce, making the cost of the final outcome of contested divorces highly unpredictable. Working out a settlement before going to court will help avoid surprises.

Attorney-Client Confidentiality – Attorney-client confidentiality protects direct communication between you and your attorney. These communications, whether in person, by phone or online, cannot be used against you in court. A breach of attorney-client privilege can seriously harm your divorce case. Avoid discussing your case with anyone other than your attorney.

Social Media – Social media posts and email communications are increasingly being used as evidence in divorce and child custody cases. These communications are not protected by attorney-client confidentiality. No matter what your intention when posting something online, consider how it could come back to haunt you in court. The best advice is to take a break from Facebook or other social media during a divorce or custody dispute.

There are many other issues that affect the emotional and financial cost of a divorce. If you are considering a divorce, call your LegalShield provider law firm first. The caring attorneys at the firm will answer your questions and do all they can to reduce the emotional and financial cost of a divorce.

 

 

Nurse Collects $500,000 after Employer Violates Employee Leave Act

Connecticut Law Tribune recognizes Attorney Thomas Bucci's succcess

 

Reprinted with permission from The Connecticut Law Tribune

By MEGAN SPICER , The Connecticut Law Tribune

December 2, 2015   

A nurse has been awarded more than $500,000 after a federal court jury found that her former employee violated the Family and Medical Leave Act. The woman's lawyer called the case unusual in that his client was seeking several years of back pay rather than just three or four months' worth.

It was also unusual because a judge recently reduced the jury's initial award, ruling that jurors failed to take into account the nurse's income that didn't come from the defendant. The jury had initially awarded $400,000 for back salary alone. After Senior U.S. District Judge described that amount as "excessive," he gave plaintiff, Connie Sue Summerlin, the choice of opting for a smaller verdict or a new trial.

Summerlin chose the smaller verdict. The court awarded her nearly $196,000 in back wages, which was doubled under the provision of the federal leave law. Including attorney fees and other costs, the total award came to $502,400.

Summerlin's attorney, Thomas Bucci of Willinger, Willinger & Bucci in Bridgeport, said he was not surprised the verdict was reduced. He added that Summerlin is "very pleased with the outcome of the trial."

Summerlin, a Brookfield resident, began working as a nurse for Almost Family, which provides home nursing and rehabilitation services, in October 2006. By April 2010, she was a registered nurse case manager, meaning she performed supervisory work as well as treating patients. That month, she fell on ice outside a patient's home and injured her hip, an injury that she later aggravated at another patient's home.

Unable to work, she took family leave in July 2010. Under the act, employees can take up to 12 weeks off in the event of injury, the birth of a baby or an illness of a close relative. They are not paid for the time off, but continue to receive benefits from the employer. Additionally, the company is supposed to give them their job back—or provide a similar position—whenever they are able to return to work.

It wasn't until February 2011 that Summerlin received permission from her doctor to return to work. When she contacted the director of Almost Family's Danbury office to ask about resuming work as a registered nurse case manager, she was told her job had been eliminated in August 2010. Instead, Almost Family offered Summerlin a per diem nursing position. The company later said Summerlin ended up declining some assignments that would have required extensive travel; Summerlin denied that allegation.

In the meantime, Summerlin applied to five different jobs with Almost Family, all of which she was qualified for, she said in her 2012 lawsuit. But she was hired for none of them. Summerlin claimed she was being retaliated against for taking family leave and filed her lawsuit.

In its defense, Almost Family argued that Summerlin did not qualify for some of the positions, such as a behavioral health case manager, because she allegedly had no interest in seeing medical patients. They also argued that Summerlin presented no evidence that would prove she was not rehired by Almost Family because of her FMLA leave.

However, during the trial, which lasted four days this past April, the plaintiff's lawyer convinced the jury that Summerlin was qualified for the jobs for which she applied. After the jury ruled in Summerlin's favor, it set about computing damages. By the court's count, she was owed wages for 1,514 days -- ranging from the day she was ready to resume working to the day the verdict was rendered.

That number of days amounts to 4.15 years. And so the jury multiplied Summerlin's annual income of $111,531 by 4.15 years. That came to about $462,000. If that verdict would have stood, Summerlin would have stood to collect nearly $1 million once the damages were doubled under the FMLA and attorney costs were added.

But Almost Family filed a motion arguing that the jury did not take into account the additional money Summerlin earned working for two other employers after she recovered from her injury. Judge Egington agreed that amount should have been subtracted from the verdict, and he came up with the $196,000 number that Summerlin ultimately accepted.

Almost Family, which operates in 14 states, is represented by Risa Boerner of Fisher & Phillips in Pennsylvania. "The company does not comment on pending legal matters," said Boerner. "That being said, the company believes it acted in accordance with applicable laws and is considering its appeal options."


 

 

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