In addition to providing and managing a senior’s daily care, family caregivers handle a great deal of paperwork. You may feel like you have created, signed, photocopied, filed, faxed and mailed every document known to man. And yet, there always seems to be someone telling you that you still don’t have the right forms to do what you need to do for your loved one. Power of attorney documents (POAs) allow family caregivers to access sensitive personal information and make vital decisions for their care recipients, but some institutions require their own documentation to authorize involvement in another’s affairs.
To simplify this process as much as possible, let’s look at some of the situations in which you will need to obtain specific permissions in addition to POA documents. These authorizations will ensure that professionals and organizations are willing to speak with you about your loved one’s finances, government benefits and more.
Power of Attorney Is Crucial for Seniors and Their Caregivers
Elder law attorneys emphasize medical and financial powers of attorney as the starting point for most seniors and their caregivers for good reason. A POA document enables a person (called the principal) to appoint an individual (called the agent) who can legally make decisions on their behalf. Without these legal preparations, caregivers would have no way of effectively advocating for their care recipients should they become incapacitated.
POAs are not necessarily infallible, though. There are different ways of writing these documents that can change the specific actions an agent can (and cannot) legally take on a principal’s behalf and when their powers begin and end. If POA documents for health care and finances are not written very carefully, caregivers can encounter problems when trying to use them to manage a senior’s care.
When power of attorney documents are being prepared, whether they name you as an agent or you are appointing an agent of your own, have an informed conversation with the attorney who is assisting you. Ask lots of “what if” questions to find out what authorities this document grants and what powers it does not. Specifically ask what criteria must be met (if any) for the agent named in the POA to be able to act on the principal’s behalf.
Some Entities Do Not Accept Power of Attorney
While POA may seem like the essential coverall legal document for caregivers and seniors, that is rarely the case. For example, many third parties (like banks) are hesitant to accept financial POAs because they may be liable for any wrongdoing that ensues if the document turns out to be invalid.
Financial institutions typically need some time to confirm the validity of a POA for finances and may even wish to consult with the attorney who prepared it. In some cases, they may also request that the agent complete an affidavit (a sworn written statement) stating they are acting legally, which will release the third party from any liability. As long as an agent is acting in the best interests of the principal and within their granted authority (i.e., doing their fiduciary duty), there should be no problems other than the slow and bureaucratic nature of this process.
Other Authorizations Needed to Manage a Senior’s Care
Social Security Authorized Representative
The Social Security Administration (SSA) requires representatives to be authorized to participate in a beneficiary’s affairs but does not recognize the POA designation. If you are trying to help a loved one with Social Security applications, claims or appeals, you will need to apply to be their authorized representative by completing the SSA-1696 Appointment of Representative Form. This application is also available to complete online here. A representative can be a relative, friend, attorney, caseworker or other qualified person, and the SSA will thoroughly vet this person before accepting their appointment.
Keep in mind that it is always preferable to speak to a live person, either by phone or in person, at the Social Security office to answer questions and ensure you are using the right forms and terminology. To learn more about becoming an SSA Authorized Representative, visit SSA.gov/representation.
Social Security Representative Payee
If you are looking to help a Social Security beneficiary manage the retirement benefits and/or Supplemental Security Income (SSI) they receive, you must apply to become their representative payee. The SSA requires all beneficiaries who are incapable of managing their own payments to have a representative payee.
While this authorization is necessary for many caregivers, it is worth noting that it involves a great deal of accountability. This position requires meticulous recordkeeping of all a beneficiary’s benefits and how they are used, so be sure you are willing and able to take on this responsibility. In instances where there is not a family member or friend available to serve as a “rep payee,” the SSA will appoint a qualified organization to manage the recipient’s benefits.
Visit SSA.gov/payee to learn more about the SSA Representative Payee Program.
When it comes to managing a loved one’s veterans benefits, there is yet another process that caregivers must go through. According to the U.S. Department of Veterans Affairs (VA), POA for finances is not a sufficient authorization for managing a veteran’s monetary benefits. If a physician or a court of law has determined a veteran (or surviving spouse of a veteran) to be incapable of managing their finances, the VA will call for the appointment of a fiduciary.
If possible, the beneficiary typically appoints who they wish to serve in this capacity, and the VA conducts a thorough investigation of the individual’s qualifications. In cases where there are no suitable family members or friends available to serve as a fiduciary, the VA will appoint a qualified professional fiduciary or organization to fill this role. As with the SSA rep payee program, appointed VA fiduciaries must carefully record transactions, keep receipts and provide accountings to the Veterans Benefits Administration.
For more information on becoming a VA fiduciary for a loved one, visit Benefits.VA.gov/Fiduciary.
Medicare cannot provide personal health information to a caregiver unless the beneficiary has submitted written authorization to the Centers for Medicare & Medicaid Services (CMS) or provides verbal permission. Over the phone, Medicare beneficiaries may be able to answer basic questions verbally, granting their caregivers authorization to discuss coverage details. If you and your loved one cannot be together on a call, try “conferencing them in” on a device that permits three-way calling.
However, having a standing authorization on file with Medicare is wise. As with all legal authorizations, it’s best to take care of the paperwork well in advance. The “1-800-MEDICARE Authorization” Form can be completed over the phone with the assistance of a customer service representative or by filling out and mailing in a hard copy. Mailing in the paper form may involve a few weeks’ delay before you are authorized to act on a senior’s behalf.
If you are looking to help a Medicare beneficiary file an appeal or complaint or request a coverage determination, you will need to be officially appointed as their representative. The Medicare Appointment of Representative form (CMS-1696) is very similar to the SSA application.
Private insurance companies often have their own versions of these forms, too, so be sure to check with insurers about their specific authorization requirements.
Be Proactive About Caregiver Documentation
Family caregivers should consider investing in a printer, scanner and/or fax machine. You’ll always need additional copies of POAs and other documents to prove you are legally able to access sensitive information, speak with important entities and make decisions about your loved one’s care and/or finances.
Do not be surprised if your authorizations are still questioned even after showing nursing home staff or bank managers a ream of documents. Individuals and organizations are often worried about the potential fallout in situations where the lines are not clearly drawn. Medical and financial information is extremely sensitive, and seniors are particularly susceptible to manipulation and elder abuse. While the paperwork is tedious, these policies and safeguards are in place for a reason. Do your part to ensure you always have the right documents in place.
When advocating for your loved one, keep in mind that many situations can be resolved by a combination of goodwill, clear explanations and reasonable questions posed to the right people. When in doubt, ask to speak to a supervisor. If one is not available, or if no amount of rational discussion seems to be effective, feel free to invoke your right to contact your legal counsel, a political representative or a bureaucrat at the state or federal level who supervises that person, organization or industry.
Taking responsibility for someone else’s well-being is a complex and monumental task. Make sure you know your rights, the rights of your care recipient and your responsibilities in the matters at hand. The sooner you and your loved one get all the proper documents in place, the less likely you are to run into problems.