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I am a wreck mentally, emotionally & physically. I give up trying to condense the background information I think is important for better insight the kind of help I need because I don’t know what kind of help I need.


My sister has clearly stolen mom’s SSDI…among several misuse/abuse rules broken. Below is what I came up with at the end of what I spent an embarrassingly long time trying to condense. I know there’s a character limit so I’m going to copy and paste whatever will paste and go from there…


Finally to the most important urgent point of this novella:
· I reported her to the SSA OIG
· To my understanding IF they decide to investigate it takes at least 6 months
· She’s already gotten December check so now 3 months of mom’s money is MIA
· What do I do to stop it? is she to keep taking mom’s money for who knows how long?
· Maybe SSA will stop sending checks??? How do I make that happen? Or get payee changed to me
· She was to write a letter to SSA requesting payee be changed over to me but now no doubt she didn’t bother
· Am I to now have to worry and wonder for months only to come up with nothing when its time to pay up for mom
· Should I speak with the nursing home about this? Would they help or hurt me?
· As the DPOA I feel like a colossal failure=feel as though I could have and should have done more…more what I can’t imagine but still fearful-Will they/state take mom from me?
· I can’t even bring mom to live with me. my situation hasn’t changed and wouldn’t have for at least 4-6 months anyway BUT
· Given the crash course I’ve received of the kind of person my sister truly is I’d go get mom RIGHT NOW regardless my situation but there’s still the money issue stopping me in my tracks made worse with missing SSDI/owing NH???no clue where I’d start until I can sort out this nightmare
· I just overall fear losing mom period…this is so horrible for me all these words will never cover it but for her…I just can’t imagine and I’m all she has…I can’t let her be there all alone period but
· Now here’s this woman with mild enough dementia that she has more good days than not and still sharp as to things being amiss…I can’t stomach it any of it she’s already so scared and lonely and now she has to wait how long until I can fix everything and get her to the only family member she has that actually cares about her wellbeing
· There must be a number of other resources for the interim of OIG investigations???
· Help in how to deal with the NH even in as far as telling them what I strongly suspect my sister has done?
· How to deal with trying to financially support mom when I’m in my circumstance that already had me scraping for $80-100 a month to make sure she has a little something to help keep her dignity/humanity/autonomy…even if just to have her favorite lotion, new underwear, kit kat bars and soda (she has her own spending acct and makes her own shopping list)
· I’ll stop there…everything I’ve said here surely will give someone who knows a lot more than me the clues to exactly what I need to do, whom to contact and so forth


I’m a little desperate to find guidance as to what to do, who to call, contact…anything to help me swiftly and thoroughly do what I can and what I should in this situation.


There are probably better areas I could post about this here and I certainly welcome any information about that as well.


That said, I’ll dive in but only with the cursory information then will jump ahead to what happened to bring me here.


My mother (65) has several serious health problems/concerns. One is vascular dementia on top of speech aphasia from at least one of her strokes which was severe embolic type.


I (49) am her closest living relative, eldest child and DPOA (full powers). I live in TX.
My “baby sister” (44) who will be referred to as BS for identity reasons lives in TN; the two of us have been close our entire lives and rarely…really never had much more

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How long has BS been representative payee? How long since the NH has been paid mom's " share of cost"?

I assume Medicaid is paying the bulk of mom bill?

I would talk with NH business office about having the NH becoming representative payee.
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Is your mom on Medicaid? If so I’m with Barb on getting with the billing Dept & Social worker at the NH to have your mom sign to have them be her representative payee for SSA. The Nh are used to this and likely have the forms to submit to SSA.

Why? Because if she’s on Medicaid she is required to do a copay of basically almost all her monthly income, like her SS, to the NH. The $ is due starting day 1 that she filed for LTC Medicaid. All those on individual LTC Medicaid only get to keep a smallish PNA personal needs allowance, which tends to be $50 or $ 60 a mo. PNA varies by state & either they can keep the PNA $ in their old bank account if they are writing a check for the copay or the NH establishes an on site trust account for the PNA $ (which mom can draw from, like to pay for beauty shoppe or get snacks or sundries). If NH becomes her representative payee, they will set up the on site trust for PNA $.

If Sissy was dealing with moms placement into the NH & did her Medicaid application, she was informed of this requirement. It is in the Medicaid application.

imo it sounds like that there may the probability that Sissy has absconded with moms $. If so, you need to ASAP, like this week, clearly find out if your mom is totally up to date with her $ copay to the NH. If her state is one at has it that if she’s still “Medicaid Pending” in her application and the NH cannot yet require the copay to them, the $ needs to build up & stay in her bank account (that gets her SS$) cause as soon as she gets eligible & approved for Medicaid, all the copay $$$ due from day 1 of her application needs to go to the NH.

If on individual LTC NH Medicaid, the copay must be paid each month in order for mom to stay ok for Medicaid. There’s no real grace period in getting the copay to the NH. Please please find out soon and not let this move into 2021 billing issues. Good luck.
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Why is your mother's SSI checks not going directly to the nursing home. Yes, I would tell the nursing home that the sister is embezzling the money right away and would also report this to SSA. How is it that YOU are POA and your SISTER is the payee for Moms SSDI? I don't understand that. Does she understand that she is legally responsible for reporting all expenditures, assets, and so on? That she can land herself in jail.
I would get a lawyer now. You are POA and can pay for this out of your Mom's funds; I am assuming you are POA on her accounts to pay her bills. I would try to get her funds either paid by SS to the nursing home directly or to your Mom's account which you have POA over; take the papers to SS office that you have filed with OIG. There needs to be a temporary stoppage of sending checks your Sister can access.
Lawyer would be my first step. Take everything you have with you, because after reading this I am real unclear about who has POA for financial and who is Representative Payee. I think this is fraud and you need professional help with it. Keep a clear diary of what is happening every single day with all of this, composition book with no torn out pages, written in ink and clearly dates. Copies of everything.
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☹️ Write down every question you have here and purse them. I’ve talked with three different SSA sources—two local offices and the man who processed it. Bird dog them for answers. Look into Adult Protective Servicesz Good luck
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Lucee, a ? for you, is mom really 65 or is she actually 66?
You wrote your mom is 65 & you’re 45, Sissys 44 so she was 16 & 21 when she had you all?
This - 65 vs. 66 - is mucho importante difference for her situation as SSDI (SS disability insurance) stops and shifts to traditional SS $ retirement income at FRA (full retirement age) which right now is 66.

If she has turned or is turning 66 while you are trying to deal with moving her SSDI to another bank acct or a new representative payee or improper use by Sissy of moms SSDI $, it’s going good to be a real paperwork nightmare as 2 different types of SSA benefit tied to moms SS number and each have different paperwork (eye roll & 😔)

Also if she was on SSDI for under 2 years, SSDI places them into state Medicaid system for health insurance. I’m guessing it’s TENNcare. I’m not familiar with TNcare, my wheelhouse is TX & LA & a lil bit MS.
BUT
if mom was on SSDI for over 2 years, then she would have gone onto federal Medicare with whatever Medicaid program TN has to mate with for secondary coverage to SSDI early MediCARE. ((SSDI imo does this 2 yr waiting period to do switch over from state Medicaid to federal Medicare as that 2 yr period is kinda viewed as a wait n’see if their disability is going to be permanent, unless it’s special category like renal dx or ALS.))

This too could involve changes in & decisions to be made for her health insurance and coverages. OR it could be that it stays the same if she was SSDI early MediCARE and it’s secondary Medicaid or perhaps a MCO (managed care organization for Medicaid) coverage for it. (As an aside, TX now does MCO for those on early Medicaid, .... it’s up to each state to determine how to deal with all this, yeah it’s confusing).

The NH she is in has dealt with stuff like this before. Between the 65/66 SSDI-2-SS$ system changes, to having to shift into traditional 65+ Medicare, there’s going to loads of paperwork. Imo you really really need to have very clear discussion with billing and the SW at your moms NH this month before the Holidays set in as to any outstanding bills, or copay to the NH and right health insurance.
Everyone is maxed out as everyone is stressing from Covid issues, so be patient but persistent. It may be that you are just going to have to do all that you can from TX, gather up all legal and SSA and banking details you have so far and then drive up to TN to be there in person to meet with a TN elder law atty, or take mom in person to get banking changed, etc. either next week or right after the Christmas break in early January 2021.
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Get APS involved ASAP.
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I believe if she's in a nursing home, they can apply to have her SSDI check diverted from the account your sister can access to them to be put towards her bill. That would help a little.

Just a note, SSDI will not accept a Power of Attorney. They have their own process that they want followed. As does the VA.
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