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Legal Steps When Dealing with a Major Illness

Posted by Anonymous

A major illness can change the course of your life. Your short and long term goals may need to be altered because of cancer, a heart attack or even the birth of a baby. However, your goals can still be your own and you can still manage the direction of your life by planning for your future. For many patients, the immediate needs are health insurance and time off from work. Longer term needs may include public assistance, creating advanced health care directives, creating a Last Will and Testament, creating a complete estate plan and naming a guardian for your children.

It is important to plan for every scenario and to have security in the fact that while you had no control over getting a horrible illness, you do have control over what you do next. So, you may wish to:

  • Review or Obtain Health Insurance Coverage: if you do not yet have health insurance then you should begin shopping for a health insurance plan. Carefully review each potential plan for pre-existing conditions exclusions. Many plans will not cover any expenses related to medical conditions or illnesses that you knew about when you purchased the medical coverage.


If you already have health insurance then it is important to carefully review your plan in order to determine what the plan will and will not cover and to estimate your potential out of pocket expenses. You should also be familiar with how to appeal the denial of an insurance claim if you believe that your claim should be covered by the terms of your health insurance contract and your health insurance company is denying your initial claim.


  • Research your Right to Take an Extended Medical Leave From Work: The federal Family and Medical Leave Act (FMLA) allows some workers to take 12 unpaid weeks off from work during a 52 week period because of an illness, birth of a child, adoption of a child or to care for an ill relative. FMLA applies to public employers and to employers who have 50 or more employees for at least 20 workweeks a year. An employee is eligible if he or she has worked for the employer for at least 1,250 hours over a 12 month period. While the time off is unpaid, the employee is legally entitled to return to his or her job at the completion of the period. State laws and company policies may entitle you to additional time off or to some paid time off so it is important to speak with your human resources department for additional information.


  • Investigate Public Assistance Programs: illness can create a financial hardship for many families. Medical expenses, even with private insurance, can be overwhelming at a time when an individual has had a reduction in income. Many families benefit from exploring federal and state public assistance programs such as Medicare, Medicaid, Social Security Disability, Food Stamps and Welfare programs. Eligibility for these programs may depend on your ability to work, your family income and your family assets. If your eligibility claim is denied then you may have the right to appeal the decision.


  • Create Advanced Health Care Directives: Many patients want to retain control over their medical decisions even if they are unable to communicate their desires to their doctors. Accordingly, they may execute an advanced health care directive or living will that describes the type of medical care that they want in certain situations and a health care proxy that designates a specific person to make the medical decisions should an individual become unable to do so. In you do not have a properly executed advanced health care directive then your doctors will look to your next of kin to make your medical decisions for you. This may create a problem for you if your next of kin is not aware of how you would like your health decisions made. It can also create a problem for your relative who is put in a difficult position of making important, often life and death, decisions for you and may make a decision that is not popular with the rest of the family. In order to avoid these problems, it is important to create an advanced health care directive by writing down your medical decisions, naming a health care proxy and executing the document according to the laws of your state. Typically, the document must be signed and witnessed in order to be enforceable.


  • Create a Last Will and Testament: It is not pessimistic, nor is it admitting defeat to develop a Last Will and Testament. Instead, many patients feel calmer and more at ease knowing that they have provided clear and legally enforceable directions about guardians for their dependents and how their assets should be divided. In order to be enforceable you must make your will without coercion or duress. You must be of sound mind and understand the important of the document that you are creating. Then, you must execute the written document according to the specific requirements set forth in state law. Many states require you to initial each page so that no one can insert or take away a page without your consent. You will also likely need to sign the will in the presence of two independent witnesses. Finally, it is important to make sure that your will is stored someplace where it will be easily accessible after your death such as your attorney's office or safety deposit box. If you do not have a properly executed will at the time of your death then your assets will be distributed according to your state laws of intestacy and a court will name a guardian for your children.


  • Name a Guardian for Your Children: If you have minor children or others under your legal guardianship then it is important to name a guardian who will care for your dependents if you should pass away. This can be accomplished within your properly executed Last Will and Testament. If you do not name the guardian then a court will name one instead and there is no guarantee that the court will name the person whom you want to raise your children. The absence of a named guardian in your will can also lead to fighting among family members which will increase the pain for your children during an already traumatic time.


  • Develop an Estate Plan: An estate plan includes many of the documents described above such as your Last Will and Testament and advanced health care directives. It may also include trusts which are designed to pass assets to certain beneficiaries according to the terms and conditions of the trust. For example, you might wish to establish a trust for your minor children but only allow them to access the money when they reach age 25. Since the trust assets have been allocated for specific beneficiaries at a time certain, the assets are no longer part of your estate and will not be included in the value of your estate for estate tax purposes. A well designed and properly executed estate plan can ensure that your personal goals are met. The absence of such a plan may mean that you pay unnecessary taxes thereby taking money away from your heirs or that the state makes inheritance decisions for you.



A major illness changes everything, at least in the short term, and it can be overwhelming to think about the financial and personal implications of an illness. However, as difficult as it can be to consider these implications, the steps described above can provide an ill person and his or her family with much needed security and peace during a challenging time.


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