1. Special Needs Trusts For P. I. Lawyers
“What you don’t know, can cost you.”

2. James M. O’Reilly Nevada’s First Certified Elder Law Attorney
Las Vegas, Nevada

3. So you settled “The Big One”
$ 1 mil settlement
$ 5000/mo. + COLA
Guaranteed for life
20 year term certain

4. “What, me worry?” Look what happened – you blew SSI
Client’s now over resource limit
Over income limit
Over both resource & income limit

5. Why quibble over SSI?
Why worry about $567/mo SSI poverty
payment?

6. Don’t bother to quibble
So long as your client is:
Employable
Employed
Insurable
Insured

7. What’s the big deal? Most SNT benes are now or likely to be:
Unemployed
Unemployable
Uninsured
Uninsurable

8. Blowing SSI can be a big deal!
The magic is $1 of SSI = Medicaid
Doctors Rx
Treatment
Hospital care
Nursing home care

9. When an injury occurs Examine your client’s core benefits
Medical insurance
Social Security
Medicare - SSDI
Medicaid - SSI
Section 8 housing
CHIPS/county programs

10. Core benefits provide Food Clothing Shelter Basic Medical Care
“Government provides the means to survive, not the means to thrive.”

11. To preserve core benefits -
Form of settlement is crucial
Outright payment
Structured settlement annuity
Blocked account
Guardianship
Special needs trust

12. Role of the SNT Preserves core benefits
Integrates with the life care plan
Enhances investment potential
Protects the disabled client
Supplements basic support

13. Role of SNT con’t Supplements basic core benefits Education
Custom living/transportation
Recreation
Companionship
Social services
New medical techniques

14. Role of SNT con’t SNTs are NOT for basic needs NO food NO clothing
NO shelter
NO basic health care
SNTs are NOT support trusts

15. The SNT Players Family - Immediate & Extended Medical team
- Doctors, Psychologists, Rehab Team
Asset Managers - Portfolio and Property
Professionals – Attorneys, CPAs
Trustee

16. The Perfect SNT Clearly ID the patient’s needs
- Assess, Plan, Implement & Document
One central point of contact
Coordinated efforts
- Family
- Care providers
- Trustee

17. Typical SNTs No one in charge Multiple accounts Poor case management
No checks & balances
Opportunities for abuse
Poor integration with public benefits

18. Find the perfect trustee
Understands public benefits
Discretion used for the beneficiary
Can invest wisely
Understands taxes
Keeps perfect books
Carries insurance/bondable
Immortal

19. SNT’s come in 2 flavors Watermelon 3rd party trusts = safer
Pomegranate
Self created trusts = dangerous

20. Watermelon Trusts General Rule - 3rd party trusts = Safer
Medical/Social prognosis
Family infrastructure & support
Current & prospective public benefits
Family’s resources

21. Trouble in the watermelon patch
Historically safe – changing politics
Ohio & NY – any discretion
Still safe in Nevada
Will the child move later?
Problems with trustees – family always mess it up

22. Pomegranate Trusts Self-settled trusts = P I awards Dangerous trusts
Must maintain categorical eligibility
Must maintain needs based eligibility
-Income limits
-Resource limits

23. 3 safe harbors for Pomegranate Trusts
42 USC 1396 (d)(4)(A) (B) & (C)
D4(A) – the workhorse
- under 65
- parent, grandparent, guardian, court
- Medicaid reimbursement
- Rule in Shelley’ case
Miller Trusts (B)

24. 3 safe harbors for Pomegranate Trusts - con’t
Pooled income trust (C)
- Master trust created by non-profit
- Family subscribes with 2 pages
- Separate accounts
- Parent, grandparent, court or guardian
- Funds go to charity at death
- None in Nevada

25. Special Needs Trusts For P. I. Lawyers
James M. O’Reilly
Las Vegas
(702)