December 2012 VOL 3, NO 6

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Financial and Legal Issues for Our Cancer Patients

Steven Kronowitz, MD, FACS

Mr Landay discussed strategies for patients with cancer to take control of their financial and legal issues, preparing for the “what ifs” while expecting the best. Decisions patients have to make include not only how to manage their disease, treatments, and overall health, but also the circumstances under which they will live, eg, home vs assisted living or nursing home. He noted that patients can’t give away their assets one day and go into a nursing home the next, although they can immediately apply for Medicare or Medicaid. He said that although a house doesn’t count, he counsels against having assets that aren’t liquid, recommending that patients consult their own lawyer.

In any case, health insurance is key. In describing how patients should assess their own situation, he listed the types of information to gather, including employment benefits, insurance coverage, Social Security information, one’s health condition, financial information, and credit status. Financial snapshots should include today’s situation and a projection of the future under different circumstances. Mr Landay recommends staying organized, keeping a list of instructions, and keeping notes about conversations in case of discrimination; he also recommends documenting all important information.

He noted that for purposes of employment there is no legal obligation to disclose a disability unless there is a danger to someone; however, reasonable accommodation requires disclosure. Accommodations inconvenience employers so one should consider their point of view. Unpaid leave from work could be considered a reasonable accommodation.

He listed applicable laws, including the Family Medical Leave Act, Employee Retirement Income Security Act, Federal Consolidated Omnibus Budget Reconciliation Act/Omnibus Budget Reconciliation Act, and Health Insurance Portability and Accountability Act, and discussed ways to replace income, eg, disability and other benefits. He recommended documenting disability, and building a case so one would be ready when it is needed. His organization’s Web site,, includes tools to apply for Social Security Disability Insurance and Supplemental Security Income to increase the chances the application will be accepted. He also discussed the possibility of returning to work after treatment and how this might affect benefits, and that patients should make sure they have property and casualty insurance and obtain coverage if they travel outside the United States, noting restrictions on preexisting conditions. He also discussed strategies to obtain health coverage for those who don’t have it, including after diagnosis.

Mr Landay then went on to discuss new uses for assets, such as early withdrawal of retirement funds, and some of the tax implications of the strategies he mentioned as well as how to protect assets such as credit, and how to use property and other collateral.

Mr Landay concluded by pointing out that estate planning isn’t just for patients with cancer; it’s for everyone, and everyone should have a healthcare power of attorney, a living will, a durable power of attorney, and other related documents.

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