Differences Between Wills and Trusts

Avoid mistakes leading to estate planning failures 

by Tom Alberts Jan 29, 2019

Summary: Estate planning failures are mostly preventable. If you have a plan, you’ve avoided one big problem, but other pitfalls lurk. Problems often arise when people fail to update their plans and inadequately address issues involving incapacity, minor and special-needs children, beneficiary designations, end-of-life care and other matters.

There are many reasons why estate plans fail, but they tend to have one factor in common – the failures are avoidable.

When creating a comprehensive estate plan, you’ll find there’s a lot to learn about how various legal documents operate separately and work together – wills, trusts, powers of attorney, advance health care directives and so on.

If you’re like most Americans, you’ve wisely relied on your attorney or consultant to explain in detail how the sea of paperwork protects your interests and provides for your beneficiaries. But in too many cases, those planning documents gather dust on a shelf or hide in a drawer. In the meantime, those documents – if they exist to begin with – can become outdated, ineffective and lead to outcomes you no longer intend or never intended.

Planning mistakes lead to unpleasant surprises in the future – disinherited loved ones, rewarded ex-spouses, disqualification for entitlements or lawsuits among warring family members – and they don’t have to happen. Your estate plan, like most things in life, requires some adjusting, maintenance and even professional help from time to time to remain viable and succeed.

Here’s a look at seven preventable failures that can make your life, and death, more difficult and give your loved ones more grief than necessary:

How do estate plans fail?

1.  Failure to create an estate plan
   There perhaps is no planning blunder greater than having no plan at all. The estates of those who lack at least a valid will are subject to the delays, expense and lack of privacy of probate and state laws of intestacy that have rigid rules on how assets are distributed. Family members may find themselves fighting among each other – and in court – over your assets. Without a will, parents can’t name a guardian to care for their minor children. If you ever become incapacitated and lack powers of attorney for health care and finances, an advance health care directive or a revocable living trust with explicit instructions, you could force your family to petition a court to appoint a guardian to make decisions for you. You may relinquish control over health care and financial decisions to a total stranger. A judge, unaware of your preferences, could appoint an ill-motivated professional guardian. Without a plan, you also lose control of the distribution of your assets when you pass away. Without a comprehensive plan, you’ll burden loved ones with the hassles of probate, be vulnerable to an unwanted guardianship and squander the ability to control your financial legacy.


2. Failure to plan for incapacity
   Your planning documents need to address more than how your property is distributed when you die. One recent study found that those who reach the age of 65 have a 50 percent chance of becoming incapacitated in their lifetime. But incapacity can happen to anyone, young or old, at any time due to an accident, disease or disability, so there’s no excuse to delay being prepared. With powers of attorney for health care and finances, you can be proactive and create a plan that names trusted people of your choosing to act on your behalf. Otherwise, your loved ones may be subject to costly court proceedings to be allowed to care for you or challenge an unwanted guardianship. Another way to plan for incapacity is to create a revocable living trust in your lifetime that can enable your successor trustee to protect and manage your assets, on your terms, upon your incapacity. Remember, a will only takes effect upon your death, and the personal representative you name in your will cannot manage your affairs while you are alive.


3. Failure to review your plan
   Peace of mind is a good thing. Out of sight and out of mind isn’t. A failure to update your plan is an oversight that can lead to its downfall in many ways. As time passes and family dynamics change, your plan must be amended to include or exclude people and provisions depending on life events and your current priorities. If you get married, divorced, remarried, have children or suffer a death in the family, it’s time to review and amend existing documents. Otherwise, you risk passing assets to an ex-spouse or leaving behind a new family member. Beneficiary designations (and alternate designations when allowed) for annuities, insurance policies, retirement accounts and bank and brokerage accounts must be up-to-date. They must be coordinated with the beneficiaries named in your will and trust for your plan to succeed. When the “wrong” beneficiaries receive assets, lawsuits from disgruntled family members challenging the estate are to be expected. Beneficiary designations supersede the provisions of a will or trust, and conflicting documents can lead to legal challenges. Regular reviews (after major life events or every few years) are required.


4. Failure to plan for children as beneficiaries
   Part your plan is to make sure the kids have a financial safety net. But naming a minor as a direct beneficiary can backfire. When beneficiaries automatically receive an inheritance at a young age, long-term financial planning usually falls by the wayside. One nightmare is not being around for your children. Another is imagining them squandering their inheritance in short order. A better option is to ensure your will or trust specifies that minor children receive their inheritance once they reach a certain age, and that your representative or trustee will be responsible for managing their assets and providing support. If the child – not your trust – is the beneficiary of your life insurance policy, the child stands to receive a lump sum at age 18 or 21. Proper trust planning is required if you intend assets to be paid out over time or when a child reaches certain milestones. Another potential mistake is adding adult children to the deed on your home as co-owners with rights of survivorship. With this arrangement, they could expose the value of the home to their liabilities (divorce settlements and debt claims come to mind) and possibly create a tax burden by receiving the home as a gift.


5. Failure to plan for special-needs beneficiaries
   Leaving assets directly to a beneficiary who has special needs and receives government assistance can be disastrous. In many cases, those with special needs rely on Social Security and Medicaid benefits to provide support over a lifetime. A windfall of income, however, could disqualify a special-needs individual from receiving government entitlements. Most of the inheritance would have to be spent down to enable the individual to once again qualify for assistance – a contradiction of your objectives. A better solution is to create a special-needs trust within your will or living trust that can be rigorously controlled by a qualified third-party successor trustee and maintain eligibility for assistance. But even a professionally designed special-needs trust is fraught with challenges because of strict rules in the administration of trust assets. Its trustee faces complex duties that require a high degree of formality, and it’s not a job easily assumed by a family member. In many cases, a professional trustee is necessary to prevent administrative failure.


6. Failure to plan if you outlive a beneficiary
   Beneficiary designations are praised for their ability to distribute assets quickly to your loved ones after your passing. They help achieve the important goal of bypassing probate. Unfortunately, our presumptions about the order of death of our beneficiaries are sometimes wrong. You need to update your beneficiary designations as circumstances in life change, otherwise assets can wind up in your probate estate or in the hands of an unintended recipient. If a beneficiary dies before you do, your plan can fail, and most banks don’t allow alternate beneficiaries for payment-on-death accounts. Proceeds from life insurance policies, retirement funds and other assets also are at stake, and alternate beneficiaries should be named, whether you’re leaving behind a checking account or a Chevrolet. Meanwhile, other problems arise when former spouses or departed family members were named as beneficiaries long ago when accounts were initially created. Your paperwork is only as good as the last time it was updated.


7. Failure to plan for end-of-life issues
   Many people avoid planning for the possibility of a terminal illness or a tragic accident. After all, it’s an unsavory subject. But if misfortune strikes, there’s no good reason to lack control of your fate or force your family or loved ones to make difficult treatment decisions on your behalf. Many people fear being placed on artificial life support or having to endure a long, slow death. A living will, also known as an advance health care directive, enables you to express your end-of-life treatment preferences. It’s important, while you can still communicate, to decide the extent of life-sustaining treatment you want – or don’t want. Otherwise, you leave treatment decisions at the sole discretion of medical professionals, who may not share your preferences or those of your family.

How can I create an estate plan?

There are numerous options and scenarios to consider when developing an estate plan that protects your legacy and achieves your objectives, and important decisions should be made with the advice of qualified lawyers and financial experts. Membership with Legacy Assurance Plan provides members with valuable resources and guidance to develop comprehensive estate plans that take life’s contingencies into consideration and leave a positive impact for generations to come. Legacy Assurance Plan members also receive peace of mind that a team of trusted, experienced professionals will assist them in developing legal, financial and tax strategies that will meet their needs today and for years to come through periodic reviews.

This article is published by the Legacy Assurance Plan and is intended for general informational purposes only. Some information may not apply to your situation. It does not, nor is it intended, to constitute legal advice. You should consult with an attorney regarding any specific questions about probate, living probate or other estate planning matters. Legacy Assurance Plan is an estate planning services-company and is not a lawyer or law firm and is not engaged in the practice of law. For more information about this and other estate planning matters visit our website at www.legacyassuranceplan.com. 

This article written and published by:
Legacy Assurance Plan
8039 Cooper Creek Blvd
University Park, Florida 34201
844.306.5272 (Phone)
info@legacyassuranceplan.com (email)
#legacyassuranceplan
@assuranceplan

Avoiding Court Appointed Guardianship | Legacy Assurance Plan

Avoinding Court Appointed Guardianship | Legacy Assurance Plan

Estate Planning with Legacy Assurance Plan allows you to plan for your future decisions, avoid court appointed guardianship and protect certain assets from the probate process. Sometimes, the hardest part of the process is just knowing where to start. At Legacy Assurance Plan, we make getting started easy. Nowhere, will you f‌ind a simpler, easier or more cost-effective way to create and maintain a comprehensive estate plan, designed specifically for you and your family. We guarantee it! Learn more about what a comprehensive estate plan can do for you on our Website https://LegacyAssurancePlan.com



This article is re-published by Legacy Assurance Plan and is intended for general informational purposes only. Some information may not apply to your situation. It does not, nor is it intended, to constitute legal or medical advice. You should consult with an attorney regarding any specific questions about probate, living probate or other estate planning matters. Legacy Assurance Plan is an estate planning services-company and is not a lawyer or law firm and is not engaged in the practice of law. For more information about this and other estate planning matters visit our website legacyassuranceplan.com. 

This article is re-published by:
Legacy  Assurance Plan
8039 Cooper Creek Blvd
University Park, Florida 34201
844.306.5272 (Phone)
info@legacyassuranceplan.com (email)
#legacyassuranceplan
@assuranceplan

Even when not in Rome, eat a Mediterranean diet to cut heart disease risk

by Rachel Bluth / Kaiser Health News Jan 23, 2019

Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease.

According to a study published Dec. 7, 2018, in JAMA Network Open, people who followed this type of diet had 25 percent less risk of developing cardiovascular disease over the course of 12 years.

The diet’s components make sense to anyone who follows nutrition news. Avoid red meat in favor of “good” fats like fish and poultry. Swap out salt for herbs and spices. Ditch butter and margarine and opt for olive oil instead. Most important, eat a lot of fruits and vegetables. Nuts are good, so are whole grains. And, every once in a while, have a glass of red wine.

Since the 1950s, researchers have pointed out this diet’s possible cardiovascular benefits. More recently, it has been credited with addressing any number of ills, including Alzheimer’s disease, asthma and helping pregnant women control factors that lead to high-birth-weight babies and contribute to obesity risk factors as kids grow.

Until the recent study, though, no randomized trials had been conducted in the U.S. to determine this diet’s long-term effects. This research also sought to shed light on the molecular underpinnings of why.

The mechanisms by which the Mediterranean diet reduced cardiovascular disease “were sort of a black box,” said Shafqat Ahmad, the lead author of the paper and a researcher in the department of nutrition at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. “We know it reduced cardiovascular risk,” he added, but the precise ways it had this effect over time “are not well understood.”

Ahmad and his co-authors, using a panel of nine biomarkers in blood tests, were able to isolate exactly why the diet reduces heart disease.

The three biggest biological mechanisms were changes in inflammation, blood sugar and body mass index.

Inflammation was the issue for Meg Grigoletti, a 23-year-old graduate student from New Jersey who switched to a Mediterranean diet when she was recovering from back surgery in 2014. Her doctors recommended it to reduce swelling, hoping it would ease the pain in her back and help her migraines.

“It’s more of a lifestyle than a diet,” Grigoletti said. “It taught me what food is good for me and what’s not.”

Researchers followed more than 25,000 women who were part of the Women’s Health Study, a survey of female health professionals older than 45. At the beginning of the study, participants completed a questionnaire on 131 different foods to assess their diets. They were then assigned different “MED scores” on a scale of 1 to 9, based on how closely they followed the Mediterranean diet.

There were three levels, people who scored between zero and 3 were on the low end, 4 to 5 was in the middle and 6 and up was categorized as a high intake of Mediterranean diet foods.

The participants’ cardiovascular health was then tracked for 12 years.

When all was said and done, those in the middle category saw a 23 percent reduction in risk, and the upper category had 28 percent less risk of cardiovascular disease.

Heart disease is the leading cause of death for both men and women, according to the Centers for Disease Control and Prevention — claiming about 600,000 lives each year. Coronary heart disease is the most common form, killing more than 370,000 people annually. Each year, about 735,000 Americans have a heart attack.

The authors pointed out that these findings do have limitations. For instance, the study relied on self-reported data, which isn’t always accurate — especially when it involves diet choices. The participants, all of whom were female health professionals, also might lean toward healthier behaviors than the rest of the population.

The results of the study weren’t a shock to Dr. Andrew Freeman, the director of cardiovascular prevention and wellness at National Jewish Health hospital in Denver. He wasn’t involved in the study but has been recommending a Mediterranean diet, or a similar version of it that emphasizes vegetables and fruit, to his patients for years.

“There’s a lot of noise out there, but the signal that’s been out there the longest is this kind of plant-based diet is the best.”

He also acknowledged that there is a lot of competing nutritional information swirling around the airwaves and the internet, which amounts to “a whole lot of hype” that makes healthy eating habits a difficult regimen for many consumers.

And doctors often don’t have clear information, either. “The vast majority of cardiologists and health providers in general have very little nutrition training,” Freeman said.

He switched to a mostly plant-based diet after his residency, and lost 35 pounds. He now recommends this approach to his patients, too. He said he has seen his patients’ conditions — heart disease, high blood pressure and diabetes — improve.

“Nutrition and lifestyle medicine is the place where there’s a chance of a cure,” Freeman said.

This article is re-published by Legacy Assurance Plan and is intended for general informational purposes only. Some information may not apply to your situation. It does not, nor is it intended, to constitute legal or medical advice. You should consult with an attorney regarding any specific questions about probate, living probate or other estate planning matters. Legacy Assurance Plan is an estate planning services-company and is not a lawyer or law firm and is not engaged in the practice of law. For more information about this and other estate planning matters visit our website at www.legacyassuranceplan.com. 

This article is re-published by:
Legacy  Assurance Plan
8039 Cooper Creek Blvd
University Park, Florida 34201
844.306.5272 (Phone)
info@legacyassuranceplan.com (email)
#legacyassuranceplan
@assuranceplan

Problems lurk when beneficiary designations, wills and trusts lack coordination

by Tom Alberts Jan 18, 2019

Summary: Common misperceptions about the way wills, trusts and beneficiary designations work together can lead to the failure of your plan for the distribution of your estate. Because beneficiary designations supersede other planning documents, a major misunderstanding is that a person’s assets will be distributed exactly as they’ve specified in their last will and testament or trust.   

If you’ve drafted a last will and testament, you may think your estate planning work is done. After all, you’ve accomplished something a majority of adults in America have yet to address or continue to ignore. 

Having a properly drafted will is a great start. It’s a better option than having no plan at all – unless you’d prefer the state to have complete control through intestacy laws to decide how many of your assets are distributed and who distributes them when the time comes.

Unfortunately, a will by itself won’t guarantee your intended beneficiaries will receive the money or property you want to leave behind. Also, a will can’t be enforced until a probate court is petitioned to appoint a personal representative and the will is proven to be valid.

What’s worse, a will is the subject of more litigation (the bulk of which originates from squabbling family members) than any other legal document because of conflicts with other planning documents, experts say.

Many people mistakenly think their estate planning affairs are in order once they’ve stated their intentions in one handy document. Indeed, a simple last will and testament may seem like a straightforward way to plan for the distribution of your estate, but this strategy can lead to disputes among loved ones, lawsuits and ill will if your paperwork’s not in order and your true intentions are ignored.

Contrary to popular belief, terms of a will are not all-controlling, and potential pitfalls await that can cause your plan to fail.

“The days of a simple will are over,” says New York-based estate planning attorney Lisa S. Hunter. “A complete estate plan includes documents that address distribution of your retirement plans and life insurance, management of any individually owned businesses, guardianship of your dependents and medical care while you are still living but unable to make your own decisions.”

If your will describes what you really intend to happen, Hunter says, then you need to make sure its provisions are coordinated with the other elements of a comprehensive estate plan.

“People circumvent their own will all the time,” Texas-based estate planning attorney Bill Dendy tells CNBC. “They’ll indicate in their will that they want their assets divided equally among their three children, but then they go and name one child as the beneficiary to their IRA account and another to their house or a joint bank account.”

What assets can avoid probate?

The way your assets are titled or transferred upon death determines whether they avoid the often long, costly and public process of probate administration. All states have legal documents that take priority over the stated intentions of a last will and testament and, upon the death of the owner, can distribute assets outside of the probate process and directly to beneficiaries. Laws vary from state to state on ways to avoid probate when distributing assets including bank accounts, retirement savings, securities, vehicles and real estate. Also, spousal survivorship rights may overrule various beneficiary designations. In many cases, if no beneficiary is named or the beneficiary dies before the owner without an alternate beneficiary, assets are payable to the owner’s estate and distributed through the probate process.

Key documents include:

• Beneficiary designations - Retirement accounts, life insurance policies and annuities include beneficiary designations. Death benefits from policies and annuities and the balance of retirement accounts are paid to designated and alternate beneficiaries. Because of tax considerations, beneficiaries are often advised to consult with a professional to determine the most advantageous method to receive the inheritance.
• Payable-on-death (PoD) designation - Owners of checking, savings and money market accounts and certificates of deposit can simply fill out a PoD form at the financial institution such as a bank, credit union or thrift to designate a beneficiary. PoD’s are sometimes called poor man’s trusts or informal trusts because they distribute assets outside of probate like a revocable living trust. Generally, alternate beneficiaries cannot be designated on individual accounts, and funds in joint spousal accounts pass to the survivor.
• Transfer-on-death (ToD) designations - In many states, ToD designations can be utilized to distribute securities, brokerage accounts, real estate and vehicles to beneficiaries. Ownership of the ToD asset is transferred to the beneficiary, and the asset is not liquidated. Keep in mind that real property owned in joint tenancy with rights of survivorship passes automatically to the surviving joint tenants, regardless of what your will or trust might say.
• Revocable living trusts - Titling assets into and properly funding a revocable living trust will expedite the settlement of your estate. However, the instructions in a trust for the distribution of assets, just like instructions in a will, should be in sync with any beneficiary and PoD and ToD designations. If instructions in the will or trust don’t line up with beneficiary designations, the intentions expressed in the will or the trust will likely fail.

When should I review my estate planning documents?

Problems – such as potential family estrangement over inheritance or assets going to the wrong people – are prone to occur when the wishes detailed in a will or trust don’t jibe with superseding instructions. One key to achieving a successful estate plan is to review your will, trust and ToD, PoD and beneficiary designations regularly to make sure they are in agreement and leave little room for a misunderstanding in the future.

It’s time to review all elements of your plan – wills, trusts, beneficiary designations, deeds, advance directives, powers of attorney – whenever there’s a marriage or divorce, the addition of a child or grandchild, a death in the family or other changes in the family dynamics. 

“Despite a testator’s best intentions to communicate his or her dispositive wishes, estate planning documents are rife for disputes among family members apt to contest their inheritance,” says a State Bar of Wisconsin report. “As a result of ambiguity in the documents, family dynamics, or feelings of unfairness among beneficiaries and family members, wills are contested with stunning frequency.”

How do I create an estate plan?

There are numerous options and scenarios to consider when developing an estate plan that protects your legacy and achieves your objectives, and important decisions should be made with the advice of qualified lawyers and financial experts. Membership with Legacy Assurance Plan provides members with valuable resources and guidance to develop comprehensive estate plans that take life’s contingencies into consideration and leave a positive impact for generations to come. Legacy Assurance Plan members also receive peace of mind that a team of trusted, experienced professionals will assist them in developing legal, financial and tax strategies that will meet their needs today and for years to come through periodic reviews.

This article written and published by:
Legacy Assurance Plan
8039 Cooper Creek Blvd
University Park, Florida 34201
844.306.5272 (Phone)
info@legacyassuranceplan.com (email)
#legacyassuranceplan
@assuranceplan

Who knew? Life begins (again) at 65

by Bruce Horovitz / Kaiser Health Jan 9, 2019

Summary: Turning 65 is a milestone, and a playbook for the next phase of life is recommended to remain physically, financially and emotionally healthy.

I was convinced I would become an adult when I turned 21. But now, I’m certain that turning 65 was the watershed moment that finally grew me up.

I’m pleased as pomegranate punch to be 65 — and alive. Not just alive and breathing, but actively engaged in making the right choices about this next chapter.

“We enter this phase of life without a playbook or anything equivalent to institutions like elementary school and college that prepare youth for adulthood,” said James Firman, CEO of the National Council on Aging, who turned 65 two years ago. “There’s really nothing to prepare us for the transition to this next phase of life.”

My playbook on preparing for life after 65:

• Consider enrolling in Medicare Part A, to cover hospitalization expenses. It works for me because my family is still covered under my wife’s health care plan. 
• Double up on checkups. My annual visit to my primary care doctor evolved into a biannual visit. “Age 65 is a time to proactively visit a geriatric physician instead of just going when you’re in trouble,” said Dr. Ardeshir Hashmi, director of the Center for Geriatric Medicine at Cleveland Clinic. “Don’t wait until things get to a point where you’re in a cycle of being in and out of the hospital all the time.” Starting at age 65, he said, these visits should last longer than the standard 20 minutes — so older patients have time to discuss what’s on their minds. Older patients who do this regularly tend to require “minor tweaks” instead of major repairs, said Hashmi.
• Schedule annual visits to the dermatologist, ophthalmologist — and visits every five years to the gastroenterologist. “Establishing a coordinated care team becomes more important at 65,” said Jean Setzfand, senior vice president of programs at AARP.
• Take the leap and sign up for long-term health insurance. My wife and I finally did after putting it off for years. Remember, it’s a lot easier — and cheaper — to get when you’re younger than 65.
• Stick to a vaccine regimen. Vaccines are important again. I’ve since received my first pneumonia vaccine. My doctor also told me to get the new shingles vaccine, Shingrix, because I developed shingles about five years ago.
• Evaluate your diet. I have mostly stopped eating red meat, except for the very occasional burger. I now opt for meals mostly composed of fruit, veggies and my new diet staple that I used to gag on as a kid: salmon.
• Bone up on Social Security. I attended a free county-funded seminar at the local library. Then, to discuss my personal needs, I met (for free) with the same volunteer who led the seminar.
• Challenge your financial plan. I changed financial advisers — based on recommendations from trusted friends — because my portfolio really matters now.
• Serve your community. I bumped-up my volunteer schedule to once a week instead of once a month at a local food pantry. I also volunteer every other week at a local homeless shelter on the 5 p.m.-to-midnight shift. I’ve most recently started to volunteer at an equestrian therapy center for kids with mental or physical handicaps. Each of my volunteer gigs reflect my personal interests.
• Stay active. I extended my daily exercise routine from five days to seven. I now swim at least five days a week; take our dog, Shadow, for 45-minute walks twice daily; and hit the weight room at least twice weekly. I also play Wallyball (a fast-moving form of indoor volleyball where the walls are considered inbounds) every week with friends who are equally motivated to stay in shape.
• Stay flexible. I learned to stretch my back muscles an extra long time before beginning any strenuous exercise. When I forget, I inevitably pay for it.
• Look to the future. I initiated “adult,” end-of-life conversations with my kids that I wish my parents had had with me.
• Get your paperwork in order. I not only updated my will but I filled out a “Five Wishes” end-of-life pamphlet created by the Aging With Dignity nonprofit group; and I got very specific, in writing, about where I want my ashes to be scattered.
• Stay connected — and not solely to devices. I stopped taking my friends for granted, banished past grudges and re-established contact with a best buddy from college whose friendship I’d foolishly let slip away. 

Age 65 is when many of us realize that we’re mortal. “This is when we start thinking about our next 20 to 30 years,” said Hashmi. “It’s when we ask: How can I be smart about investing my remaining decades wisely?”

Eric Tyson, author of “Personal Finance After 50 for Dummies,” theorizes that one of the most powerful undercurrents of turning 65 is how it affects the working lives of so many Americans. It’s when the majority go from working full time to working less — or not working at all, he said. “The best scenario is when this change can unfold over many years instead of all at once.”

It has for me. Things started changing at age 62, when I took a buyout from USA TODAY, where I’d worked for 20-plus years as a marketing reporter. I’m now a freelance writer and media training consultant.

So, at 65, the one thing I’ve opted to put off for at least a few years is retiring. While 65 still remains the most common retirement age, more and more folks are breaking that tradition, said AARP’s Setzfand.

Call it living with purpose.

Turning 65 is not just an extension of middle age. It’s a new life chapter that’s waiting to be written. “It’s a new stage of life that reminds us we don’t have forever,” said Firman. About a decade ago, at age 56, Firman had a quintuple bypass operation. His father, grandfather and uncle all died of heart disease in their 40s and 50s.

Firman isn’t distraught over the family genes he inherited. Instead, he’s celebrating his survival. When he turned 65 two years ago, he said, he had a realization that the real purpose of aging is to make the world a better place. “Life is a gift,” he said. “Success in old age starts with an attitude of gratitude.”

It seems Firman and I share one common trait: We both grew up at 65.

KHN’s coverage of these topics is supported by John A.
Hartford Foundation, The SCAN Foundation and  The Silver Century Foundation.

This article is re-published by Legacy Assurance Plan and is intended for general informational purposes only. Some information may not apply to your situation. It does not, nor is it intended, to constitute legal or medical advice. You should consult with an attorney regarding any specific questions about probate, living probate or other estate planning matters. Legacy Assurance Plan is an estate planning services-company and is not a lawyer or law firm and is not engaged in the practice of law. For more information about this and other estate planning matters visit our website at www.legacyassuranceplan.com. 

This article is re-published by:
Legacy Assurance Plan
8039 Cooper Creek Blvd
University Park, Florida 34201
844.306.5272 (Phone)
info@legacyassuranceplan.com (email)
#legacyassuranceplan
@assuranceplan

Check your medical records for dangerous errors

by Judith Graham/Kaiser Health News Jan 7, 2019

Summary: Mistaken information in medical records can lead to serious problems, including misguided evaluations, diagnoses and treatments. Under federal law, patients have a legal right to review their records for correctness and omissions.

When Liz Tidyman’s elderly parents moved across the country to be closer to their children and grandchildren years ago, they carried their medical records with them in a couple of brown cardboard folders tied with string.

Two days after their arrival, Tidyman’s father fell, which hadn’t happened before, and went to a hospital for an evaluation.

In the waiting room, Tidyman opened the folder. “Very soon I saw that there were pages and pages of notes that referred to a different person with the same name — a person whose medical conditions were much more complicated and numerous than my father’s,” she said. 

Tidyman pulled out sheets with mistaken information and made a mental note to always check records in the future. “That was a wake-up call,” she said.

Older adults have cause to be careful about what’s in their medical records. Although definitive data aren’t available, the Office of the National Coordinator for Health Information Technologyestimates that nearly 1 in 10 people who access records online end up requesting that they be corrected for a variety of reasons.

In the worst-case scenario, an incorrect diagnosis, scan or lab result may have been inserted into a record, raising the possibility of inappropriate medical evaluation or treatment. This, too, is something that Tidyman’s father encountered soon after moving from Massachusetts to Washington. (Her parents have since passed away.)

When both his new primary care physician and cardiologist asked about kidney cancer — a condition he didn’t have — Tidyman reviewed materials from her father’s emergency room visit. There, she saw that “renal cell carcinoma” (kidney cancer) was listed instead of “basal cell carcinoma” (skin cancer) — an illness her father had mentioned while describing his medical history.

“It was a transcription error; something we clearly had to fix,” Tidyman said.

Omissions from medical records — allergies that aren’t noted, lab results that aren’t recorded, medications that aren’t listed — can be equally devastating.

Susan Sheridan discovered this nearly 20 years ago after her husband, Pat, had surgery to remove a mass in his neck. A hospital pathology report identified synovial cell sarcoma, a type of cancer, but somehow the report didn’t reach his neurosurgeon. Instead, the surgeon reassured the couple that the tumor was benign.

Six months later, when Pat returned to the hospital in distress, this error of omission was discovered. By then, Pat’s untreated cancer had metastasized to his spinal canal. He died 2½ years later.

“I tell people, ‘Collect all your medical records, no matter what’ so you can ask all kinds of questions and be on the alert for errors,” said Sheridan, director of patient engagement with the Society to Improve Diagnosis in Medicine.

In less dire scenarios, a patient’s name, address, phone number or personal contacts may be incorrect, making it difficult to reach someone in the event of an emergency or causing a bill to be sent to the wrong location. Or, your family history may not be conveyed accurately. Or, you may not have received a service recorded in your record — for instance, a stress test — and want to contest the bill.

Dave deBronkart, a 68-year-old cancer survivor and patient activist, recounts mistakes he and his family have experienced. Once, he checked a radiology report through a Boston hospital’s patient portal. It had his name on it but identified him as a 53-year-old woman.

In another instance, the records that accompanied deBronkart’s mother to a rehabilitation center after a hip replacement incorrectly identified her as having an underactive thyroid when in fact she had an overactive thyroid. DeBronkart’s sisters, who asked to look at their mother’s chart, discovered the mistake and had it fixed on the spot, so she wouldn’t get potentially harmful medications.

“It’s important for people to realize how easy it is for mistakes to get into the system and for nobody to know it. And that can cause downstream harm,” deBronkart said.

The law that guarantees your right to review your medical record, the Health Insurance Portability and Accountability Act of 1996, offers some recourse: If you think you’ve discovered an error in your medical record, you have the right to ask for a correction. (For more information about how to obtain your record, see my earlier column here.)

Start by asking your doctor or hospital if they have a form (either a paper or electronic version) you should use to submit a suggested change.

A simple error such as a wrong phone number can be corrected by drawing a thin line through the material and writing a suggested change in the margins or making an electronic note. A more complicated error such as incorrect description of your symptoms or a diagnosis that you’re contesting may require a brief statement from you explaining what material in the record is wrong, why and how it should be altered.

Physicians and hospitals are required to respond in writing within 60 days, with the possibility of a 30-day extension. (Some states set shorter deadlines.) But medical providers are not obligated to accept your request. If you receive a rejection, you have the right to add another statement contesting this decision to your medical record. You can also file a complaint with the government office that oversees HIPAA  or a state agency that licenses physicians.

Devin O’Brien, senior counsel with The Doctors Company, the largest physician-owned medical malpractice firm in the U.S., notes that rejections can be warranted when facts or medical judgments are in question. An example might be a patient who wants a doctor’s notes about potentially excessive opioid use eliminated from the record. “The patient may say I don’t have a problem, I don’t know what you’re talking about, but the physician may think the patient has an issue,” O’Brien said.

Another example might be a patient who wants a diagnosis eliminated from a medical record, because it might compromise her ability to get insurance coverage. That wouldn’t be an acceptable reason for making a change, experts said.

For more information about correcting errors in medical records, see this guide to getting and using your medical record  from the Office of the National Coordinator for Health Information Technology, this explainer from patient advocate Trisha Torrey, and these descriptions of your HIPAA rights from the Privacy Rights Clearinghouse and the Center for Democracy & Technology.

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

This article is re-published by Legacy Assurance Plan and is intended for general informational purposes only. Some information may not apply to your situation. It does not, nor is it intended, to constitute legal or medical advice. You should consult with an attorney regarding any specific questions about probate, living probate or other estate planning matters. Legacy Assurance Plan is an estate planning services-company and is not a lawyer or law firm and is not engaged in the practice of law. For more information about this and other estate planning matters visit our website at www.legacyassuranceplan.com. 

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