Benefits for Older New Yorkers

Many public programs are available to seniors in need.  The New York City Department for the Aging (DFTA) provides a guide to benefits and entitlements for older New Yorkers.

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Most of the agencies listed have automated answering systems needing touch tone responses from the caller. There may be a waiting time of up to several minutes, depending on the agency. The time may be longer to reach an operator, if using a rotary telephone.

ACCESSNYC can help improve your access to benefits. ACCESSNYC is a free electronic information and screening tool that allows people of all ages to identify and screen their eligibility for over 30 City, State and Federal human service benefit programs.

Seniors can visit http://www.nyc.gov and search for “Access NYC” to screen their eligibility for several of the programs listed in this booklet. These include SNAP, Medicaid, HEAP, and the Senior Citizen’s Rent Increase Exemption and Veterans’ Exemptions.

Based on information you enter into the system, ACCESS NYC will help fill out some of the applications to make the process easier. It will also provide information on agency office locations that are near you. The tool is available in seven languages: English, Spanish, Chinese, Russian, Korean, Haitian Creole, and Arabic.

Download The NYC.gov Benefits Guide here: http://www.nyc.gov/html/dfta/downloads/pdf/publications/Benefits1017.pdf

For more information call 311 or visit: www.nyc.gov

 

Stay Safe Online This Holiday Season

This holiday season is ripe for a lot of spam, online scams, viruses, malware and ransomware.  All can be at the least annoying and at best extremely costly.

Here are some tips I use to stay safe when online:

•Do not click to open attached files in your email that come from unknown senders. Files with extensions .zip, .pdf, .exe should be a red flag. Also, even if sender appears to be known, i.e. Chase Bank, UPS, that doesn’t mean it is from Chase bank or UPS. A known sender means a friend you have emailed before. Note that even if it is a known sender, if you are not expecting anything be cautious. Look for errors in the message or language. If unsure, call or email that person or company separately—not as a reply email— and ask them if they sent you something.

•Think twice before clicking on links in emails. If your bank or credit card sends you an email with a link, don’t click it. Log in via your bank or credit cards website from your browser. The ‘from’ column of your email may be disguised and read like a familiar or bonafide email address but may actually be from elsewhere.

• Be cautious of any suspicious pop ups of applications showing up on your pc.

• Most email applications will allow you to mark spam as ‘spam’ or ‘junk’. This is a good practice If you get frequent spam from same sender. It should keep the spam from showing up again in your inbox.

For more detailed information about online safety see below.

Yes, you can click theses links from me 🙂

-Brian

https://staysafeonline.org/stay-safe-online

https://securingtomorrow.mcafee.com/consumer/consumer-threat-notices/10-tips-stay-safe-online/

 

Pressure sores: Causes, treatment, and prevention

Informative medical information: 

Via MEDICAL NEWS TODAY, By Christian Nordqvist

Pressure sores can affect people who spend a long time in one position, for example, because of paralysis, illness, old age, or frailty.

Also known as pressure ulcers and bedsores, pressure sores can happen when there is friction or unrelieved pressure on one part of the body.

People who cannot make even small movements are at risk of pressure sores.

The sores can affect any part of the body, but the bony areas around the elbows, knees, heels, coccyx, and ankles are more susceptible.

Bedsores are treatable, but, if treatment comes too late, they can lead to fatal complications.

The prevalence of pressure sores in intensive care units in the United States (U.S.) is estimated to range from 16.6 percent to 20.7 percent.

Fast facts on pressure soresHere are some key points about pressure sores. More detail and supporting information is in the main article.

  • Pressure sores, pressure ulcers, or bedsores commonly affect people who cannot move easily.
  • They are more likely to affect the bony parts of the body.
  • The sores develop in stages. Identifying them in the early stage enables treatment and reduces the risk of complications.
  • Moving patients frequently is key to preventing pressure sores.

Symptoms

[Pressure sores]There are varying stages of severity of pressure sore.

Pressure ulcers can affect patients who are unable to move because of paralysis, illness, or old age.

Bed-bound patients are most at risk of developing bedsores on the bony parts of their body, such as the ankles, heels, shoulders, coccyx or tailbone, elbows, and the back of the head.

Patients who use a wheelchair have a higher risk of developing pressure sores on their:

  • buttocks and tailbone
  • spine
  • shoulder blades
  • back of arms or legs

Pressure sores develop in four stages.

  1. The skin will look red and feel warm to the touch. It may be itchy.
  2. There may be a painful open sore or a blister, with discolored skin around it.
  3. A crater-like appearance develops, due to tissue damage below the skin’s surface.
  4. Severe damage to skin and tissue, possibly with infection. Muscles, bones, and tendons may be visible.

An infected sore takes longer to heal, and the infection can spread elsewhere in the body.

Causes and risk factors

Anyone who stays in one place for a long time and who cannot change position without help is at risk of developing pressure sores. The ulcers can develop and progress rapidly, and they can be difficult to heal.

Sustained pressure can cut off circulation to vulnerable parts of the body. Without an adequate supply of blood, body tissues can die.

According to Johns Hopkins Medicine, a sore can develop if blood supply is cut off for more than 2 to 3 hours.

Pressure ulcers are usually caused by:

Continuous pressure: if there is pressure on the skin on one side, and bone on the other, the skin and underlying tissue may not receive an adequate blood supply.

Friction: For some patients, especially those with thin, frail skin and poor circulation, turning and moving may damage the skin, raising the risk of bedsores.

Shear: If the skin moves one way while the underlying bone moves in the opposite direction, there is a risk of shearing. Cell walls and minute blood vessels may stretch and tear.

This can happen if a patient slides down a bed or a chair, or if the top half of the bed is raised too high.

Injured tissue can develop an infection. This can spread, leading to serious illness.

Risk factors

[Pressure sores immobility]Pressure sores mainly affect those who are less mobile, or restricted to one position, such as older people or those with mobility impairments.

Pressure ulcers are more common among those who:

  • are immobilized because of injury, illness, or sedation
  • have long-term spinal cord injuries

Patients with long-term spinal cord injuries or neuropathic conditions, including diabetes, have reduced sensation.

They may not feel a bedsore developing, so they continue to lie on it, making it worse.

Patients who cannot move specific parts of their body unaided have a greater risk of developing pressure ulcers.

Factors that increase the risk include:

  • Older age as skin gets thinner and more vulnerable with age
  • Reduced pain perception, due, for example, to a spinal cord or other injury, as they may not notice the sore
  • Poor blood circulation, due to diabetes, vascular diseases, smoking, and compression
  • Poor diet, especially with a lack of protein, vitamin C, and zinc
  • Reduced mental awareness, due to a disease, injury, or medication, can reduce the patient’s ability to take preventive action
  • Incontinence of urine or feces can cause areas of permanently moist skin, increasing the risk of skin breakdown and damage

A low or high body mass index (BMI) increases the risk.

A person with a low body weight will have less padding around their bones, while those with obesity can develop sores in unusual places. Studies show that people with a BMI of 30 to 39.9 have a 1.5 times higher rate of developing pressure ulcers.

Diagnosis, treatment, and management

[Pressure sores relief]Placing a pillow under the affected area can help to alleviate pressure and symptoms.

A doctor will diagnose a pressure ulcer through a visual examination.

The physician will ask about recent medical history and they will check the size and shape of the sore, and if there is any oozing or weeping.

If the patient is not in residential care, a doctor may teach them how to carry out regular daily checks on themselves.

People should report any sign of a pressure sore to the doctor.

Treatment

Treating pressure ulcers is not easy.

An open wound is unlikely to heal rapidly. Even when healing does take place, it may be inconsistent, because of the damage to skin and other tissues.

Less severe pressure ulcers often heal within a few weeks with proper treatment, but serious wounds may need surgery.

The following steps should be taken:

  • Remove the pressure from the sore by moving the patient or using foam pads or pillows to prop up parts of the body.
  • Clean the wound: Minor wounds may be gently washed with water and a mild soap. Open sores need to be cleaned with a saline solution each time the dressing is changed.
  • Control incontinence as far as possible.
  • Remove dead tissue: A wound does not heal well if dead or infected tissue is present, so debridement is necessary.
  • Apply dressings: These protect the wound and accelerate healing. Some dressings help prevent infection by dissolving dead tissue.
  • Use oral antibiotics or antibiotic cream: These will can help treat an infection.

In the early stages, people may treat ulcers at home, but more severe ulcers will need dressing by a health care professional.

Negative pressure wound therapy

Also known as vacuum-assisted therapy, this procedure involves the attachment of a suction tube to the bedsore. The tube draws moisture from the ulcer, drastically improving the healing time and reducing the risk of infection.

Wounds heal within around 6 weeks at half the cost of surgery.

Surgery

Some bedsores may become so severe that surgical intervention is necessary.

Surgery aims to clean the sore, treat or prevent infection, reduce fluid loss, and lower the risk of further complications.

A pad of muscle, skin, or other tissue from the patient’s body is used to cover the wound and cushion the affected bone. This is known as flap reconstruction.

Prevention

Even with excellent medical and nursing care, bedsores can be hard to prevent, especially among vulnerable patients.

Preventing bedsores is easier than treating them, but this too can be challenging.

Tips to reduce the risk of a bed sore developing include:

  • moving the patient at least every 15 minutes for wheelchair users and at every 2 hours for people in bed
  • daily skin inspections
  • keeping the skin healthy and dry
  • maintaining good nutrition, to enhance overall health and wound healing
  • quitting smoking
  • exercises, even if they must be carried out in bed, with assistance, as they improve circulation.

Patients should mention any possible bed sores to their health care worker or doctor.

A physical therapist can advise on the most appropriate positions to avoid pressure sores.

Complications

[Pressure sores cellulitis]Cellulitis is a possible complication of bed sores.

Without treatment, bed sores can lead to serious complications.

Cellulitis is a potentially life-threatening bacterial infection of the skin, from the surface to the deepest layer of skin. Cellulitis can result in septicemia, or blood poisoning, and the infection can spread to other parts of the body.

Bone and joint infections can arise if a pressure ulcer spreads to the joints or bones. This can result in damage to cartilage and tissue, and a reduction in limb and joint function.

Sepsis, in which bacteria can enter through sores, especially advanced ones, and infect the bloodstream. This can lead to shock and organ failure, a life-threatening condition.

There is a higher risk of developing an aggressive Cancer in the skin’s squamous cells if the patient has bedsores.

Outlook

Stage 2 bedsores can heal within 1 to 6 weeks, but ulcers that reach stage 3 or 4 may take several months, or they may never heal, especially in people with ongoing health problems.

With the appropriate measures, patients and medical staff can significantly reduce the risk of developing pressure ulcers.

_____________________________________________________________________________________

Download: Bedsore Legal and Medical Facts Booklet>

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What is Probate? 6 Steps Outlined:

When a loved one dies there are significant legal issues that come up for the executor or administrator.

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Probate is simply the process of the Court validating the Last Will and Testament of a deceased person, referred to as a “decedent” and having the executor appointed. Some of the duties of the executor are paying the decedent’s final bills and estate taxes and/or inheritance taxes (if any), and then distributing what’s left of the decedent’s assets to his or her heirs.

6 Basic steps of Probate outlined:

1. Filing the Will and petition at the probate court in order to be appointed executor or personal representative. In the absence of a Will, we will petition the court on behalf of heirs to be appointed “administrator” of the estate.

2. Marshaling, or collecting, the assets.

This means that you have to find out everything the deceased owned. You need to file a list, known as an “inventory,” with the probate court. It’s generally best to consolidate all the estate funds to the extent possible. Bills and bequests should be paid from a single checking account, either one you establish or even better, one that we set up as your attorney, so that we and you can keep track of all expenditures.

3. Taxes, taxes, taxes. If a state or federal estate tax return is needed it must be filed within nine months of the date of death. If you miss this deadline and the estate is taxable, severe penalties and interest may apply. If you do not have all the information available in time, we can file for an extension and pay your best estimate of the tax due.

4. Filing tax returns. A final income tax return for the decedent must be filed and, if the estate holds any assets and earns interest or dividends, an income tax return for the estate as well. If the estate does earn income during the administration process, it will have to obtain its own tax identification number in order to keep track of such earnings. Our probate attorneys are well versed in the latest probate tax issues.

5. Distributing property to the heirs and legatees. Generally, executors do not pay out all of the estate assets until the period runs out for creditors to make claims, which can be as long as a year after the date of death. But once the executor understands the estate and the likely claims, he or she can distribute most of the assets, retaining a reserve for unanticipated claims and the costs of closing out the estate.

6. Filing a final account. The executor must file an account with the probate court listing any income to the estate since the date of death and all expenses and estate distributions. Once the court approves this final account, the executor can distribute whatever is left in the closing reserve, and finish his or her work. We have the experience to make every step of the probate process less burdensome for our clients so they can arrive at the final accountings with a sense of ease.

Q&A:

Do I need to get the original Will?

Yes. A photocopy of the Will is not considered a legal document and ordinarily will not be honored. If you are the executor it’s likely you have it stored in a safe place such as a safe deposit box. Or perhaps it’s with the attorney that drafted the Will. Note that even though another attorney may have drafted the document or represented you or your family before, there is no obligation to continue use that attorney and we can certainly assist and save you time, money and anguish.

How long should it take to “settle” an estate?

It depends on the individual facts and circumstances involved in the particular estate. With no major disputes among the beneficiaries or the need to commence a lawsuit to collect a debt owed to the decedent or to pursue a wrongful death claim, an estate where no estate tax returns are required should be wound up in less than a year after the decedent has died. With our hands-on approach, clients aren’t lost in the shuffle of a large firm. We expedite to our clients satisfaction.

Removing the burden for an executor and family.

We are proud of our reputation in helping those in need especially around a time of grief. We have provided relief and comfort for countless families while expediting the process and clarifying the ‘legalease’ for our clients. Whether it’s a probate or non-probate estate each client gets the personal attention they need to make the process less of a burden. Feel free to call us for more information or email me personally at braphan@raphanlaw.com.

-Brian

10 Really Good Year-End Tax Tips

Via Screen Shot 2017-12-12 at 4.37.03 PM
By Maryalene LaPonsie, Contributor

With the end of the year looming, the window is quickly closing for taxpayers who want to minimize the taxes they will pay next spring.

What’s more, for those trying to make year-end adjustments to their income and deductions, a tax reform bill being discussed in the District of Columbia has created uncertainty. Although it’s tempting to take action based on expected changes to the law, some finance experts urge caution. “Until the law becomes formal, we have to be very careful,” says Kristin Bulat, senior vice president of strategic resources for insurance and consulting firm NFP.

Taxpayers shouldn’t make rash decisions based on a bill which may or may not become law. However, there are some smart money moves that can help hedge against potential changes.

 

Here are 10 tax tips to reduce the amount of federal income tax you’ll pay for 2017.

1. Make 401(k) and HSA contributions. People can make tax deductible contributions to traditional IRAs up to April 17 of next year. However, the door closes on Dec. 31 for 401(k) and health savings account contributions.

 

Taxpayers with a qualified high-deductible family health insurance plan can deduct up to $6,750 in contributions to a health savings account. Those age 55 or older are eligible for an additional $1,000 catch-up contribution.

Tax deductible contributions to a traditional 401(k) are capped at $18,000 for 2017. Workers age 50 and older can make an additional $6,000 in catch-up contributions.

 

[See: How to Pay Less Tax on Retirement Account Withdrawals.]

 

2. Avoid taxes on a RMD with a charitable donation. Seniors who have a traditional 401(k) or IRA account must take a required minimum distribution each year once they reach age 70 1/2. Those who don’t need this money for living expenses may want to consider having it sent directly to a charity as a qualified charitable distribution. “If you take it out as a qualified charitable distribution, it doesn’t increase your adjusted gross income,” says Mike Piershale, president of Piershale Financial Group in Crystal Lake, Illinois. “It can also hold down the amount of Social Security that is taxed.”

 

3. Hold off on mutual fund purchases. People should be wary of buying mutual funds at this time of year if they will be held in a taxable account. You could get hit with a tax bill for year-end dividends even if you just purchased shares. “It’s a big surprise,” says Emilio Escandon, managing principal of the Northeast region for accounting firm MBAF. To avoid paying those additional taxes, Escandon recommends consulting with a broker before making a purchase to find out when distributions are made.

4. Convert money from a traditional to a Roth IRA. Withdrawals from traditional IRAs are taxed in retirement, but distributions from Roth IRAs are tax-free. Money can be converted from a traditional to a Roth account prior to retirement, but taxes must be paid on the converted amount.

Tax experts say people should be careful that the amount they convert doesn’t bump them into the next tax bracket. The one exception might be those who expect to pay the alternative minimum tax for 2017. The top AMT tax bracket is 28 percent, but it is targeted for elimination in the D.C. tax reform bill. If that happens, people paying the AMT this year could find themselves in a higher tax bracket next year. As a result, some people may be better off converting a greater amount in 2017. “If you were considering [a Roth conversion] and you’re in the AMT, do it this year,” Escandon says.

 

5. Harvest your capital losses. If you own stocks that have lost money, you can sell them and deduct up to $3,000 on your federal taxes. Just be careful not to violate the wash sale rule, which would disallow the deduction. This rule states you cannot purchase the same or a substantially similar stock within 30 days before or after the sale.

 

6. Pick up capital gains if you’re in a low tax bracket. The end of the year is also a good time for some people to sell stocks that have appreciated significantly in value. “If you are in the 10 or 15 percent bracket, the long-term gains [tax rate] is zero,” Piershale says. “Sell them in the 15 percent [tax bracket] and buy the stock back the next day to reset the basis.” By resetting the basis, taxpayers can minimize the amount of tax they could pay on future gains.

 

7. Use your flexible spending account balance. Workers who have flexible spending accounts need to use up their balances soon. These accounts have “use it or lose it” provisions in which money reverts back to an employer if not spent. While some companies provide a grace period for purchases made in the new year, others end reimbursements at the close of the calendar year. “So it’s time to get a new pair of glasses or something like that,” Bulat says.

8. Bunch your itemized deductions. Taxpayers who itemize deductions for 2017 may not need to in 2018. “They’re talking about almost doubling the standard deduction next year,” Piershale says of the tax reform discussion. “Because of that, we’ve been talking [with clients] about maximizing itemized deductions this year.” People may want to prepay their January mortgage payment in December, make additional charitable donations or pull the trigger on big purchases before the end of the year. “Buy the car this year if you are deducting the sales tax,” Piershale says.

[Read: Year-End Retirement Planning Deadlines for 2017.]

 

9. Prepay your state income taxes. Another major change that is brewing in D.C. concerns state income taxes. “Both the House and the Senate bills eliminate the state income tax deduction,” Escandon says. Should that happen, taxpayers won’t be able to deduct any payments made in 2018, even if they are for the 2017 tax year. Therefore, Escandon recommends that anyone who thinks they will owe state income tax in April to send in that money this December.

 

10. Consider whether to defer your bonus. Some workers might want to consider asking their bosses to wait until after the new year to send bonus checks. “Tax rates may be dropping for some, thanks to tax reform,” Escandon says. If that happens, people may be better off delaying income until 2018 when it could be taxed at a lower rate.

There’s only a month to go until we ring in 2018. If you want to minimize your 2017 federal income taxes, the time to act is now.