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HomeMy WebLinkAbout01-13-12• T T OZ `6I ~Inf uo palu~a~ azann s.zalla"I :00800' T T OZ 'oN ait,~ oI paxaput pug ~Iuno~ pu~Izauuxn~ ui pal~go.~d s~nn IT?tY1 eau p~ `T TOZ `8Z aunf uo paip xu~z3 at.rey~ aa~.z0 •S •IuauzelsaZ pug IItM Is~'I .zau palnaaxa `~tuLnl~suuad `~iluno~ pu~Taaquzn~ `~Ioug ~o Iuaptsa.z ~ `~re.z3 ai.~ey~ aa~a0 `I T OZ `LZ aun f u0 •{, aaua.za~a.~ ~q uta.~au pal~zodzoaut pug «d„ Iigiuxg s~ olazau paua~Il~ st IuaurelsaZ pug IIiM Is~7 s~xu~~,~ ai.re~ aa~.zrJ3o ~Cdoa Iaa.z.zoa pug anzl ~ •pas~aaaQ `~~,~ at.rey~I aa~arJ ~o Iuauz~IsaZ pug iITtY1 Is~'I auI ut aalsruZ s~ pal~u~isap si pug `Isms xu~~3 airey~ a~L.zrJ auI ~o aalsruZ auI si uoililad aui • £ SZOL I `~iu~nl~isuuad `~Iuno~ pu~Itaquzn~ `~Ioug `IaaalS u~~ O I Z i I~ saptsa.z ~Clluauno Dunn I~nptniput Ilnp~ u~ `ano.zrJ atz~y~ aut~Ig st ~auoililad au.I. •Z pas~aaaQ `~rez3 ai.z~y~ aa~.zrJ 3o IuaurelsaZ p~ TiTtY, Is~'~ auI yin pal~aaa Is~Z ssazdxa u~ st `IstuZ ~re~3 atz~~ a~LZrJ au.L • T :smollo~ s~ saan~~oa~aul I~oddns ut pug `IsruZ spaaN IetaadS ~ al~aaa oI IsruZ ssa.zdxa u~~o suzzaZ ~ipoy~ oI uotltlad stul saltd Dunn `•~•d `su.z~ax a8 Ilannpl~~ `s~au.~oll~ eau ~iq `.~auoiltlad `aalstu,l,~o ~flto~d~a zau ui `ano.~0 aired aureig sautoa `MON QI~IH ~.L2If10~ QI~'S d0 S~JQflf ~'IgF~02II~IOH ~H.L O.I, ~.~_ r-, ,., ~ . ~___ ._-, u~ ,__ -.T .LSf12i.L SQ~~l~T 'I~I~~dS ~.L~'~~ OZ _ - isnx.t ao sI~I~.I. ~,~IQOI~ of uoili~a ,. ~- ,; - -_-~;,- ;_ `~J .~ - ~LLIfla~ - NOLL~F~ 'IIAI~ c~ ' , 00800-1 IOZ 'CAN ~; _ N~'ISIAIQ Z2I110~ ~SN~'Hd2I0 `Sd~'Id NOL~IY~IO~ 30 .L2If10~ A.LI~If10~ QN~''I2I~gL~if1~ 3H.L III • 2I~NOI,LI.L~d `~3.I.Sf1?I.L `~AO?IrJ ~I2IdY~T ~I~IIH'I~ .I.SfI2I.L ~IN~2I3 3I2IdL~T ~~~'2IrJ ~H.L pub ?IN~3 ~I2I~L~i ~~d2IJ d0 ~.Ld.LS~ ~I NI .~ 6. The Last Will and Testament of Grace Marie Frank created a Trust for the benefit of her son, Lee Alexander Frank, which was subject to the following provisions: (a) to pay the net income together with so much of the principal thereof as Trustee shall consider advisable for the Beneficiary's support and care after taking into consideration all other readily available assets, sources of income and other resources. (Exhibit "A" at 3, Item VI (a)). 7. The Last Will and Testament of Grace Marie Frank nominates and appoints her daughter, Elaine Marie Grove and her sons, Richard Mark Frank and Clarence Michael Frank, as Co-Trustees of any trust created by her Will. (Exhibit "A" at 3, ITEM VII). 8. Richard Mark Frank and Clarence Michael Frank are unwilling to serve as Trustees at this time, but, are willing to serve as individual Successor Trustees to Elaine Marie Grove (Exhibit "A" at 3, ITEM VII). 9. Efforts to fulfill the purpose of the Grace Marie Frank Trust are being frustrated and a modification of administrative terms of the Trust are necessary to effectuate its overall purpose of supplementing the care and special needs of the Deceased's son, Lee Alexander Frank. 10. Lee Alexander Frank has been deemed disabled by the Social Security Administration due to his mental and physical disabilities; and Lee Alexander Frank receives Social Security Disability income. A true and correct copy of the Social Security Administration Notice of Decision -Fully Favorable is attached hereto as Exhibit "B" and incorporated herein by reference. 2 11. As a mentally and physically challenged individual, the son of the Deceased, Lee Alexander Frank, born August 25, 1968, eligibility for other benefits such as Medicaid and Department of Public Welfare Programs is jeopardized by the accumulation of income and assets having a total cash value in excess of Two Thousand Dollars ($2,000.00). 12. Under the Social Security Act, a disabled person under the age of 65 may deposit his own money into a trust established for the benefit of that person, without adverse effect on the eligibility of that person for any governmental benefit, provided that all amounts remaining in the trust upon the death of such person up to an amount equal to the total medical assistance paid on behalf of that person during the period the trust was in existence will devolve to the Estate. 42 U.S.C. § 1396 p(d)(4). The Pennsylvania Public Welfare Code, 62 P.S. § 1414, and Regulations of the Pennsylvania Department of Public Welfare, 55 Pa. Code § 178.7, are consistent. 13. A Special Needs Trust designated the "Lee Alexander Frank Special Needs Trust", as set forth in its entirety and attached hereto as Exhibit "C", and as consistent with. the provisions of federal and state law, will promote the health, welfare, treatment and rehabilitation of Lee Alexander Franlc by assuring his continued eligibility for federal and state benefits and by facilitating the prudent management of his income and assets by a trustee. 14. The proposed Trustee is Elaine Marie Grove, the sister of Lee Alexander Frank, who has no interest adverse to Lee Alexander Frank. 15. The Consent of the proposed Trustee is attached hereto as Exhibit "D". 16. The Consent of the Pennsylvania Department of Public Welfare is attached hereto as Exhibit "E". 3 17. Lee Alexander Franlc currently receives Eight Hundred Forty-Six Dollars ($846.00) gross/Seven Hundred Forty-One Dollars ($741.00) net per month in Social Security Disability income, and pays Six Hundred Dollars ($600.00) per month rent for his apartment and the remaining amount goes to pay his car insurance and food. 18. Lee Alexander Frank will inherit Forty-Seven Thousand One Hundred Forty-Five Dollars and Thirteen Cents ($47,145.13) which will fund the Trust, pursuant to the Last Will and Testament of Grace Marie Frank. l 9. Should the Trust be funded pursuant to the Last Will and Testament of Grace Marie Frank, Lee Alexander Frank would lose his eligibility to receive Medicaid and Department of Public Welfare benefits and exhaust the Trust. 20. The Grace Marie Frank Trust cannot fulfill its purpose to supplement the special needs to the deceased's son, Lee Alexander Frank, if the Trust is funded and Lee Alexander Frank receives an inheritance, as he is entitled to, pursuant to the Last Will and Testament of Grace Marie Frank. 21. The terms of the Grace Marie Frank Trust must be modified to deem the Trust a Special Needs Trust to benefit the Deceased's son, Lee Alexander Frank. Wherefore, the Petitioner, Elaine Marie Grove, as Trustee of the Grace Marie Frank Trust, respectfully request that this Honorable Court enter a decree providing the following relief: (a) Grant this Petition to Modify Terms of Trust; (b) Approve the creation of a Special Needs Trust for the benefit of Lee Alexander Frank; (c) Grant such other relief as this Honorable Court deems fair and equitable; and 4 (d) Grant Caldwell & Kearns, P.C. reasonable attorney fees and costs, in the amount of Two Thousand Five Hundred Dollars ($2,500.00). Respectfully submitted, Date: January 12, 2012 By: Eliz eth H. Feather, Esquire Attorney I.D. 92618 Caldwell & Kearns, P.C. 3631 North Front Street Harrisburg, PA 17110-1533 (717) 232-7661 (717) 232-2766 efeather(a,ckle ag_l.net Attorney for Petitioner 11313-001-182464 5 n ...:. == ~~' ' ' r ~ y ~ I T ~ I"i": '~~ ~ ~ 1... : c.:.._ i"~~~ . _..7 ~~i i~ '.. ~ ~ .. `r C n -i ~:. ~~ c~~a~~ ~~~~ ~~~ I, GRACE MARIE FRANK, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament hereby revoking all prior Wills and Codicils. ITF,i I I. I di~~ect that the e~~penses of my last illness ar~d funeral Ne paid from my estate as soon as practicable after my death. ITEM II. I direct that my real estate be held for the use of my children during their lifetimes. My children residing in my residence shall pay the real estate taxes, insurance, utilities and the cost of repairs. My son, LEE ALEXANDER FRANK, shall have a lifetime lease in the real estate for him to use as his residence. At tl~e time of the death of my son, LEE ALEXANDER FRANK, if none of my other children choose to live in the property, the property may then be sold with the proceeds distributed pursuant to the residuary paragraph (Item IV below). If the property has not been sold when only one of my children is still living, the property shall become the sole and separate property of that child. PAGE I OF IV ITEM III. I hereby reserve unto myself the right to make a list disposing of items of personal property. If I make such a list, from time to time, it will be signed and dated, will describe the items to be devised and the individual devisees thereof. If no such written statement or list is found and properly identified by my Executor within thirty (30) days after the issuance of Letters Testamentary or Letters of Administration, it shall be presumed that there is no such statement or list and any subsequently discovered statement or list shall be ignored. Any reasonable distribution expenses incurred with respect to tangible personal property, including but not limited to packing, shipping, storage and insurance expenses, shall be paid by my Executor as an administrative expense of my estate. These items are being distributed as a remembrance of my life. ITETvi IV. I give, devise .and bequeath ali of the rest, residue acid remainder of my estate of whatsoever kind and wheresoever situate, in equal shares to my son, CLARENCE MICHAEL FRANK, per stirpes; my son, JEFFREY EUGENE FRANK, per stirpes; my daughter, ELAINE MARIE GROVE, per stirpes; my son, RICHARD MARK FRANK, per stirpes; and my son, LEE ALEXANDER FRANK, per stirpes. ITEM V. I direct that the bequest to my son, LEE ALEXANDER FR.AN-K, shall be held in trust for him. ITEM VI. In the event that a Trust is created by or as a result of any part of this Will for my son, LEE ALEXANDER FRANK, the duties of the Trustee shall be to administer the terms and conditions of the Trust as follows: PAGE II OF IV a. To pay the net income together with so much of the principal thereof as Trustee shall consider advisable for the beneficiary's support and care after taking into consideration all other readily available assets, sources of income and other resources. b. If the beneficiary shall die before receiving final distribution of his entire share, the undistributed balance shall be distributed outright to my residuary beneficiaries, per stirpes. ITEM VII. I nominate and appoint my daughter, ELAINE MARIE GROVE, my son, RICHARD MARK FRANK, and my son, CLARENCE MICHAEL FRANK to serve as Co-Trustees for any Trust established in or created by this Will. If any of one of them is unable or unwilling to serve the others may serve together or serve alone. ITEM VIII. I nominate and appoint my daughter, ELAINE MARIE GROVE, my son, RICHARD MARK FRANK, and my son, CLARENCE MICHAEL FP;,ANK, Co-Executors of this my Last Will. If any of one of them is unable or unwilling to serve the others may serve together or serve alone. ITEM IX. I direct that my Co-Executors and Co-Trustees or their successors shall not be required to give bond for the faithful performance of the appointed duties in any jurisdiction. ITEM X. I direct that all taxes due at my death or as a consequence of my death shall be paid from my residuary estate. PAGE III OF rV IN WITNESS WHEREOF, I have hereunto set my hand and seal this . ~,~_ day of ~K iv p , 2011. /'~ ~ ~G~' / Dom, ,//C/~/~r~l' CrRACE MARIE FRANK /. ~~... S ig~~n~jature~ ~ ,.~ / ~-y t~ Print or Type Name Signature -~. r- ~ . ~ Gt, ~rc~. E ~c;~~~ ~ rlc~ -Lt- Print or Type Name ~~~ skcL y 1~~ ~~'~,~ SOCIAL SECURITY ADMINISTRATION -' U A '~ ~ ~~N ~~~ o'- Refer Toy 190-64-3952 ~'~'ISTRD`~ Lee A Frank 212 4th St. Eno1a, PA 17025 Office of Disability Adjudication and Review SSA ODAR Hearing Ofc 8th Floor 2 North 2nd Street Hai7-isburg, PA 17101 Date: October 7, 2009 NOTICE OF DECISION - FITLLY FAVORABLE I have made the enclosed decision in your case. Please read this notice and the decision carefully. This Decision is Fully Favorable To You Another office will process the decision and send you a letter about your benefits. Your local Social Security office or another may first ask you for more information. If you do not hear anything for 60 days, contact your local office. The Appeals Council May Review The Decision (7n Its Own The Appeals Council may decide to review my decision even though you do not ask it to do so. To do that, the Council must mail you a notice about its review within 60 days from the date shown above. Review at the Council's own motion could make the decision less favorable or unfavorable to you. If You Disagree With The Decision If you believe my decision is not fully favorable to you, or if you disagree with it for any reason, you may file an appeal with the Appeals Council. How to File an Appeal To file an appeal you or your representative must request that the Appeals Council review the decision. You must make the request in writing. You may use our Request for Review form, HA-520, or write a letter. You may file your request at any local Social Security office or a hearing office. You may also mail your request right to the Appeals Cowicil, Office of Disability Adjudication and Review, 5107 Leesburg Pike, Falls Church VA 22041-3255. Please put the Social Security number shown above on any appeal you file. Form HA-L761U3-2007) See Next Page Lee A Frank (190-64-3952) Time to File an Appeal Page 2 of 3 To file an appeal, you must file your request for review within 60 days from the date you get this notice. The Appeals Council assumes you got the notice S days after the date shown above unless you show you did not get it within the S-day period. The Council will dismiss a late request unless you show you had a good reason for not filing it on time. Time to Submit New Evidence You should submit any new evidence you wish to the Appeals Council to consider with your request for review. How an Appeal Works Our regulations state the rules the Appeals Council applies to decide when and how to review a case. These rules appear in the Code of Federal Regulations, Title 20, Chapter III, Part 404 (Subpart J) . If you file an appeal, the Council will consider all of my decision, even the parts with which you agree. The Council may review your case for any reason. It will review your case if one of the reasons for review listed in our regulation exists. Section 404.970 of the regulation lists these reasons. Requesting review places the entire record of your case before the Council. Review can make any part of my decision more or less favorable or unfavorable to you. On review, the Council may itself consider the issues and decide your case. The Council may also send it back to an Administrative Law Judge for a new decision. If No Appeal and No Appeals Council Review If you do not appeal and the Council does not review my decision on its own motion, you will not have a right to court review. My decision will be a final decision that can be changed only under special rules. Form HA-L76 (03-2007) See Next Page Lee A Frank (190-64-3952) If You Have Any Questions Page 3 of 3 If you have any questions, you may call, write or visit any Social Security office. If you visit an office, please bring this notice and decision with you. The telephone number of the local office that serves your area is (717)243-0085. Its address is Social Security, 200 S Spring Garden St, Carlisle, PA 17013-2656. Peter V. Train Administrative Law 3udge Enclosures: Form HA-L15 (Fee Agreement Approval) Decision Rationale cc: Debra K Wallet 24 N. 32nd St. Camp HiII, PA 17011 Form HA-L76 (03-2007) SOCIAL SECURITY ADMINISTRATION Office of Disability Adjudication and Review ORDER OF ADMINISTRATIVE LAW JUDGE IN THE CASE OF CLAIM FOR Period of Disability and Disability Insurance Lee A Frank Benefits (Claimant) (Wage Earner) 190-64-3952 (Social Security Number) I approve the fee agreement between the claimant and his representative subject to the condition that the claim results in past-due benefits. My determination is limited to whether the fee agreement meets the statutory conditions for approval and is not otherwise excepted. I neither approve nor disapprove any other aspect of the agreement. YOU MAY REQUEST A REVIEW OF THIS ORDER AS INDICATED BELOW Fee Agreement Approval: You may ask us to review the approval of the fee agreement. If so, write us within 15 days from the day you get this order. Tell us that you disagree with the approval of the agreement and give your reasons. Your representative also has 15 days to write us if he or she does not agree with the approval of the fee agreement. Send your request to this address: Jasper J. Bede Regional Chief Administrative Law Judge SSA ODAR Regional Ofc 4th Floor East 300 Spring Garden St Philadelphia, PA 19123 Fee Agreement Amount: You may also ask for a review of the amount of the fee due to the representative under this approved fee agreement. If so, please write directly to me as the deciding Administrative Law Judge within 15 days of the day you are notified of the amount of the fee due to the representative. Your representative also has 15 days to write me if he/she does not agree with the fee amount under the approved agreement. Form HA-L15 (03-2007) See Next Page Lee A Frank (190-64-3952) Page 2 of 2 You should include the social security number(s) shown on this order on any papers that you send us. lsl ~.~~ (/. U. ~7Qif/f1 Peter V. Train Administrative Law Judge October 7, 2009 Date Form HA-L15 (03-2007) SOCIAL SECURITY ADMINISTRATION Office of Disability Adjuclication and Review DECISION IN THE CASE OF CLAIM FOR Period of Disability and Disability Insurance Lee A Frank Benefits (Claimant) 190-64-3952 (Wage Earner) (Social Security Number) JURISDICTION AND PROCEDURAL HISTORY This case is before the undersigned on a request for hearing dated July 17, 2008 (20 CFR 404.929 et seq.). The claimant appeared and testified at a hearing held on June 16, 2009, in Harrisburg, PA. Jan D. Howard-Reed, an impartial vocational expert, also appeared at the hearing. The claimant is represented by Debra K Wallet, an attorney. The claimant is alleging disability since April 15, 2007. ISSUES The issue is whether the claimant is disabled under sections 216(1) and 223(d) of the Social Security Act. Disability is defined as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months. There is an additional issue whether the insured status requirements of sections 216(1) and 223 of the Social Security Act are met. The claimant's earnings record shows that the claimant has acquired sufficient quarters of coverage to remain insured through March 31, 2012. Thus, the claimant must establish disability on or before that date in order to be entitled to a period of disability and disability insurance benefits. After careful review of the entire record, the undersigned finds that the claimant has been disabled from April 15, 2007 through the date of this decision. The undersigned also finds that the insured status requirements of the Social Security Act were met as of the date disability is established. APPLICABLE LAW Under the authority of the Social Security Act, the Social Security Administration has established afive-step sequential evaluation process for deterixuning whether an individual is disabled (20 CFR 404.1520(a)). The steps are followed in order. If it is determined that the See Neat. Page Lee A Frank (190-64-3952) Page 2 of 5 claimant is or is not disabled at a step of the evaluation process, the evaluation will not go onto the neat step. At step one, the undersigned must determine whethet• the claimant is engaging in substantial gainful activity (20CFR 404.1520(b)). Substantial gainful activity (SGA) is defined as work activity that is both substantial and gainful. If an individual engages in SGA, he is not disabled regardless of how severe his physical or mental impairments are and regardless of his age, education, or work experience. If the individual is not engaging in SGA, the analysis proceeds to the second step. At step two, the undersigned must determine whether the claimant has a medically determinable impairment that is "severe" or a combination o.f impairments that is "severe" (20 CFR 404.1520(c)). An impairment or combination of impairments is "severe" within the meaning of the regulations if it significantly limits an individual's ability to perform basic work activities. If the claimant does not have a severe medically determinable impairment or combination of impairments, he is not disabled. If the claimant has a severe impairment or combination of impairments, the analysis proceeds to the third step. At step three, the undersigned must determine whether the claimant's impairment or combination of impairments meets or medically equals the criteria of an impairment listed in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525, and 404.1526). If the claimant's impairment or combination of impairments meets or medically equals the criteria of a listing and meets the duration requirement (20 CFR 404.1509), the claimant is disabled. If it does not, the analysis proceeds to the next step. Before considering step four of the sequential evaluation process, the undersigned must first determine the claimant's residual functional capacity (20 CFR 404.1520(e}). An individual's residual functional capacity is his ability to do physical and mental work activities on a sustained basis despite limitations from his impairments. In making this finding, the undersigned must consider all of the claimant's impairments, including impairments that are not severe (20 CFR 404.1520(e) and 404.1545; SSR 96-8p). Next, the undersigned must determine at step four whether the claimant has the residual functional capacity to perform the requirements of his past relevant work (20 CFR 404.1520(f)). If the claimant has the residual functional capacity to do his past relevant work, the claimant is not disabled. If the claimant is unable to do any past relevant work or does not have any past relevant work, the analysis proceeds to the fifth and last step. At the last step of the sequential evaluation process (20 CFR 404.1520(g)), the undersigned must determine whether the claimant is able to do any other work considering his residual functional capacity, age, education, and work experience. If the claimant is able to do other work, he is not disabled. If the claimant is not able to do other work and meets the duration requirement, he is disabled. Although the claimant generally continues to have the burden of proving disability at this step, a limited burden of going forward with the evidence shifts to the Social Security Administration. In order to support a finding that an individual is not disabled at this step, the Social Security Administration is responsible for providing evidence that demonstrates that other See Next Page Lee A Frank (190-64-3952) Page 3 of 5 work exists in sigiuficant numbers in the national economy that the claimant can do, given the residual functional capacity, age, education, and work experience (20 CFR 404.1512(g) and 404.1560(c}). FINDINGS OF FACT AND CONCLUSIONS OF LAW After careful consideration of the entire record, the undersigned makes the following findings: 1. The claimant's date last insured is March 31, 2012. 2. The claimant has not engaged in substantial gainful activity since April 15, 2007, the alleged onset date (20 CFR 404.1520(b) and 404.1571 et seq.). 3. The claimant has the following severe impairment(s): learning disability and degenerative disc disease (20 CFR 404.1520(c)). The above impairment(s) causes more than minimal functional limitations. 4. The severity of the claimant's impairment meets the criteria of section 12.OSC of 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 444.1520(d) and 404.1525). In making this finding, the undersigned considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and SSRs 96-4p and 96-7p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and SSRs 96-Zp, 96-6p and 06-3p. The claimant's impairment meets listing 12.OSC. The "paragraph C" criteria ofthis listing are met because the claimant has mental retardation initially manifested before age 22 with a valid verbal, performance, or full scale IQ of 60 through 70 and a physical impairment imposing an additional and significant work-related limitation of function. lit order to evaluate the claimant's mental abilities, a consultative examination was done on August 3, 2009 by clinical neuropsychologist and licensed psychologist Christopher Royer Psy.D.. An IQ test was given with a resulting valid verbal score of 64, performance score of 73, and a full scale IQ of 65. In addition, Dr. Royer assessed that the claimant has marked restrictions in interacting appropriately with the public; interacting appropriately with co-workers; responding appropriately to work pressures in a usual work setting; and responding appropriately to changes in a routine work setting. He assessed extreme difficulties in understanding and remembering detailed instructions; carrying out detailed instructions; and making judgments on simple work-related decisions. Dr. Royer assigned a GAF score of 42 (Exhibit l OF). In regards to the onset of the claimant's mental impairment, there is no indication of any traumatic brain injury or other preceding event which would have caused a decline in mental status. There is a history of special education and IEP services during school. The claimant struggled academically and had to repeat grades. There ti~+as a prior IQ test given on June 22, See Next Page Lee A Frank (190-64-3952) Page 4 of 5 1978 at age 9 which indicates a full scale IQ score of 90 (Exhibit 1F). However, IQ results obtained between ages 7 and 16 should only be considered current for 2 years. Therefore, this previous IQ score is not a valid indication of the claimant's mental functioning into adulthood. Given the evidence that the claimant had learning impairments in childhood, it is reasonable to assume that the claimant's impairment manifested prior to age 22. In addition to the mental impairment, the claimant suffers from hack problems which also cause significant work-related limitation of function. The claimant alleges back pain which causes limitations in lifting, squatting, bending, sitting, and kneeling (Exhibit 4E). An EMG test was done on March 5, 2008 which indicates acute lesions around the L4-S2 vertebral levels. An MRI of the spine was done on Apri123, 2008 which indicates spondylolisthesis of L4 on LS and LS on S1, multilevel degenerative changes, and probable disc protrusion at L4-LS (Exhibit 3F), On August 25, 2008, Ronald W. Lippe, M.D. of Orthopedic Institute of Pennsylvania concurs that the claimant has spondylolisthesis at L4-LS with significant foramina) stenosis. Dr. Lippe suggested that surgical intervention might be a possible treatment option (Exhibit 9F). The claimant first attempted to treat the back pain with medications, epidural injections, physical therapy, and a TENS unit. During physical therapy it was noted that lumbar mobility was moderately restricted with forward and backward flexion, and repeated efforts uicreased the lower extremity radicular symptoms (Exhibit 3F). The claimant did receive some relief from the physical therapy, but the claimant reports that the back pain continues to be disabling. After considering the evidence of record, the undersigned finds that the claimant's medically determinable impairments could reasonably be expected to produce the alleged symptoms, and that the claimant's statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible. Controlling weight. is given to the opinion of Dr. Royer because it is from an acceptable medical source, is from an examining physician with a specialty in psychology, and is generally consistent and supported by the objective medical evidence as a whole (20 CFR 404.1527). His opinion clearly refers to significantly subaverage general intellectual functioning with deficits in adaptive functioning which fit the criteria of listing 12.05. The "paragraph C" criteria of this listing are met because of the additional functional limitations set forth by the claimant's back impairment. The State agency medical consultant's physical assessment and psychological consultant's mental assessment are given little weight because another medical opinion is more consistent with the record as a whole, and the consultative examination report and other evidence received at the hearing level shows that the claimant is more limited than determined by the State agency consultants. 5. The claimant has been under a disability as defused in the Social Security Act since April 15, 2007, the alleged onset date of disability (20 CFR 404.1520(4)). See Neat Page Lee A Prank (190-64-3952) Page 5 of 5 DECISION Based on the application for a period of disability and disability insurance benefits protectively filed on February 13, 2008, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since April 15, 2007. Peter V. Train Administrative Law Judge October 7, 2009 Date IN RE: ESTATE OF GRACE MARIE FRANK And THE GRACE MAREIE FRANK TRUST ELAINE MARIE GROVE, TRUSTEE, PETITIONER IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS, ORPHANS' COURT DIVISION NO. 2011-00800 CIVIL ACTION -EQUITY SPECIAL NEEDS TRUST This Trust is created, and this Trust Agreement is entered into, this day of 2012, by Elaine Marie Grove, as Settlor, (hereinafter referred to as "Settlor"), and Elaine Marie Grove, as Trustee, (hereinafter referred to as "Trustee"). This Trust is established pursuant to the Social Security Act, 42, U.S.C. § 1396p(d)(4)(A), the Pennsylvania Public Welfare Code, 62 P.S. § 1414, and Pennsylvania Department of Public Welfare regulations, 55 Pa. Code § 178.7(f)(1), and shall be known as "The Lee Alexander Frank Special Needs Trust". ARTICLE I: TRUST ESTATE 1.1 Transfer to Trust. The Settlor will, upon the signing of this Trust Agreement and without consideration, transfer and deliver to the Trustee the sum of Forty-Seven Thousand One Hundred Forty-Five Dollars and Thirteen Cents ($47,145.13) receipt of which is hereby acknowledged, and other property which, together with the interest thereon, shall. ctitute the Trust estate. 1.2 Beneficiary. The Trust estate shall be held, managed, administered, and distributed by the Trustee as hereinafter provided, for the sole benefit of Lee Alexander Frank, who presently resides at 632 Enola Road, Enola Cumberland County Pennsylvania 17025, hereinafter referred to as "Beneficiary". The Beneficiary is disabled as defined at Sections 216(1) and 223(d) of the Social Security Act, as a result of the diagnosis of learning disability and degenerative disc disease. 1.3 Additions to Trust Estate. The Settlor, and any other person, including the Beneficiary, shall have the right at any time to add property acceptable to the Trustee to this Trust, and such property, when received and accepted by the Trustee, shall become part of the Trust estate, provided however, that no funds shall be placed in the Trust after the Beneficiary reaches the age of sixty-five (65) years unless authorized and appropriate under then-existing law. ARTICLE II: IRREVOCABILITY OF TRUST 2.1 This Trust shall be irrevocable and shall not be altered, amended, or terminated by any person except by the Trustee as is: (A) permitted by law while retaining the irrevocable nature of this Trust; and (B) necessary to respond to: (i) the requirements of an administrative agency with the authority to dispense public benefits or regulate this Trust or Trustee; or (ii) changes in statutory, regulatory or case law, in order to fulfill the Settlor's intent to obtain maximum public benefits for the Beneficiary and maximum legal protection of the assets of the Trust. ARTICLE III: DISTRIBUTION 3.1 During the lifetime of the Beneficiary, the Trustee shall have the power to distribute to or apply for the benefit of the Beneficiary, such amounts of income and principal as the Trustee may from tune to time determine to be necessary or appropriate for the Beneficiary's special needs and comfort. Expenditures from the Trust must have a reasonable relationship to the special needs of the Beneficiary, as further set forth at section 3.3 hereof. 3.2 The Trustee shall make distributions to or for the benefit of the Beneficiary after considering federal, state, or local entitlements, programs, and benefits, and the rules of eligibility therefore, in order to meet the special needs of the Beneficiary while maximizing the Beneficiary's eligibility for such federal, state, and local entitlements, programs, and benefits. It is the intent of the Settlor to maintain the highest degree of federal, state, or local entitlements, progra.ins and other benefits for the Beneficiary, while also seeking to provide for the special needs of the Beneficiary and improve the quality of the Beneficiary's life. Accordingly, the Trust principal and income may be used only as a supplement to, and shall not replace or be used in substitution for any governmental benefit for which the Beneficiary may be or become eligible, including Medical Assistance, (MA), Supplemental Security Income, (SSI), or any other governmental program or benefit. In determining the Beneficiary's eligibility for such governmental benefits, no part of the principal or income of this Trust shall be considered to be available to the Beneficiary as a resource or asset. 3.3 "Special needs" shall mean those items, products, goods, or services, not covered by Medical Assistance or other federal, state, or local govermmental programs, or by private insurance or other third party liability source, which can be provided to the Beneficiary in order to improve her quality of life, and are related to the treatment or rehabilitation of the Beneficiary's disability, or relieve the consequences of such disability, or provide the Beneficiary the customary and reasonable opportunities of life enjoyed by individuals who are not disabled. Special needs shall include, but need not be limited to, medical, dental, and opthalmology or optometry services, (including eyeglasses), nursing and custodial care, psychiatric/psychological services, recreational therapy, occupational therapy, vocational therapy, physical therapy, durable medical equipment, prosthetic devices, special rehabilitative services or equipment, disability-related training, education, transportation and travel, dietary needs and supplements, items of personal comfort and care, personal support services, professional services, supplemental health insurance, and appropriate housing, (either leased in the name of the Beneficiary and guaranteed by the Trust; or purchased in the name of the Trust as owner), together with reasonable and necessary modifications, repairs, furnishings, and maintenance for any such property. 3.4 The Trustee shall secure the approval of the Court of Common Pleas for any single expenditure of Trust principal in excess of five-thousand ($5,000.00) dollars. 3.5 The Trustee shall at all times act according to the general standards of law applicable to Special Needs Trusts, and according to the particular terms of this Trust, and with prudence and fidelity to the purposes of this Trust, as the Trustee inay in his discretion deem advisable for the welfare of the Beneficiary. 2 ARTICLE IV: TERMINATION OF TRUST AND DISTRIBUTION OF PRINCIPAL 4.1 Upon termination of this Trust the Trustee shall notify the Commonwealth of Pennsylvania and reimburse the Commonwealth and any other governmental entity for any unpaid valid lien for Medical Assistance or other governmental benefits provided to the Beneficiary during the time this Trust was in existence, as required by 42 U.S.C. §1396p(d)(4)(A) and 62 P.S. X1414, or any successor statutes, from assets remaining in this Trust at that time. 4.2 If the Trustee determines that it is impractical to administer this Trust because it is or becomes too small to justify maintaining a trust, or because it is no longer suitable for the Beneficiary's needs, the Trust may be terminated, and the Trustee shall, after malting any reimbursement to the Commonwealth required by law, distribute the principal and income of the Trust as ordez•ed by the Court if the Beneficiary is a minor or incapacitated person, or otherwise to the Beneficiary outright or as the Beneficiary directs. 4.3 This Trust shall terminate upon the earlier of: A. The death of the Beneficiary; or B. The exhaustion of the assets of the Trust under circumstances malting it unliitely that further contributions to the Trust will occur or be permitted under law. 4.4 Written notice of the death of the Beneficiary or other termination of this Trust shall be provided to the Pennsylvania Department of Public Welfare, Third Party Liability Unit, Special Needs Trusts, P.O. Box 8486, Harrisburg, PA 17105-8486. The Trustee shall also request from that Department a statement of claim. 4.5 Any portion of the Trust estate remaining at the death of the Beneficiary, after reimbursement to the United States and/or the Commonwealth as required by section 4.1 hereof, and after any payments set forth at section 5.1(M) hereof, shall be paid to the heirs of the Beneficiary as designated by Will or statute. ARTICLE V: POWERS OF TRUSTEE 5.1 In order to carry out the purposes of this Trust, the Trustee, in addition to all other powers granted by law, shall have the following powers: A. To retain or invest in, and to sell or exchange, all forms of real and personal property, at such prices and on such terms and conditions as may be desirable, in accordance with and as authorized by the Prudent Investor Rule, 20 Pa. C.S.A. §7201, et seq. B. To open, maintain, close, or transfer assets held in any banlt, mutual fund, money znarltet, stock, bond, or other financial or investment account, in the name of this Trust. C. To manage, control, repair, and improve all Trust property, real or personal. D. To enter into or to modify or rescind any contract or agreement on behalf of the Trust. E. To adjust or compromise any claim for or against the Trust, F. To borrow money and to mortgage or pledge or otherwise encumber Trust assets as the Trustee may, in its discretion, deem advisable. G. To exercise any options, rights and privileges available to or acquired by Trustee for the purchase of any assets. H. To lease for any term, exchange or sell at public or private sale any Trust asset; and grant options to lease for any term, exchange or purchase any Trust asset, in each case without Court Order. I. To hold investments in bearer form, or register them in Trustee's name or in the name of its nominee. J. To subscribe for stock and bond privileges, give proxies, join in any merger, reorganization or voting trust with respect to investments under this Trust, and vote or refrain from voting any securities. K. To make distributions under this Trust in cash, in kind, or partly in each. L. To pay any taxes, (whether of the Trust or the Beneficiary), interest, and/or penalties; and to apply for and collect tax refunds and interest. M. To settle the Beneficiary's personal estate by payment of administrative expenses, valid debts, taxes, and the payments required by section 4.1 hereof, in the order of priority provided by law. N. In accordance with the provisions of Article II, the Trustee may amend this Trust so that it conforms to federal and state law governing public benefits and programs for which the Beneficiary is or may be eligible, including, but not limited to, Medical Assistance (MA) and Supplemental Security Income (SSI). ARTICLE VI: DUTIES AND COMPENSATION OF THE TRUSTEE 6.1 Allocation of Income and Principal. The Trustee shall determine what is income and what is principal of the Trust and what expenses, costs, taxes, and charges of any kind whatsoever shall be charged against income and what shall be charged against principal in accordance with the applicable statutes of the United States and the Commonwealth of Pennsylvania. 6.2 Limitation on Trustee's Liability. No Trustee appointed under this Trust shall at any time be held liable for any act or failure to act or any act or failure to act of its agent or of any other person in com~ection with the administration of the Trust estate, unless caused by Trustee's gross negligence or by a willful commission of an act in breach of trust. 6.3 Compensation. The Trustee, if a corporation or governmental agency, may retain from the Trust estate from time to time those fees which are reasonable and customary for the services rendered. 6.4 Bond, No bond shall be required of the original Trustee hereunder or of any successor Trustee. 4 6.5 Successor Trustee. If the Trustee named above should be unable or unwilling to serve, then Clarence Michael Frank shall act as Trustee. If Clarence Michael Frank is unable or unwilling to serve, then Richard Marls Frank will act as Trustee. If Elaine Marie Grove, Clarence Michael Frank and Richard Mark Frank are all unable or unwilling to serve as Trustee, then the Guardian of the Estate of the Beneficiary may appoint another person or corporate fiduciary to act as successor Trustee. A Trustee may resign by giving written notice to the Settlor or Guardian of the Estate of the Beneficiary. If t11e Settlor is deceased and no Guardian is appointed, the Trustee then servizlg may name a successor Trustee in writing, delivered to and following consultation with the Beneficiary. 6.6 Removal of Trustee. In the event that a Beneficiary, Guardian of a Beneficiary, or other interested person believes that it is not in the best interests of a Beneficiary for the Trustee to continue to serve as Trustee, the Beneficiary, Guardian, or interested person may petition the Court, upon cause shown, to z•emove the then-existing Trustee and appoint a successor Trustee. 6.7 Accounting. The Trustee may, but shall not absent an Order of Court be required to, prepare and file accountings for any Court, with notice and copy to the Department of Public Welfare. Prior to delivering all of the property of any Trust hereunder to a successor Trustee or the malting of any final or complete distribution of Trust principal, the Trustee may require an approval of an accounting by written release and discharge either from the Beneficiary or the Court. 6.8 Professional Assistance. The Trustee may retain, at reasonable and customary rates, the services of such attorneys, accountants, investment advisors, or other professionals as may be necessary for the proper administration of this Trust. ARTICLE VII: BURIAL FUND 7.1 The Trustee shall establish an irrevocable, pre-paid fund sufficient to cover the reasonable expenses of the Beneficiary's funeral, burial, and grave marker. ARTICLE VIII: SPENDTHRIFT PROVISION 8.1 The interest of the Beneficiary in the principal and/or income of this Trust shall not be subject to anticipation or to the claims of his/hez• creditors, or creditors of others, including creditors of any spouse of a married Beneficiary, nor to legal process, and may not be voluntarily or involuntarily alienated or encumbered. ARTICLE IX: CONSTRUCTION OF TRUST 9.1 Governing Law. This Trust shall be governed by the laws of the Commonwealth of Pennsylvania. 9.2 Copies. Photocopies of this Trust shall be as valid as the original. IN WITNESS WHEREOF, this Trust Agreement has been signed by the Settlor and the Trustee on this day of , 2012. Witness Witness Witness Witness 11313-1-182478 SETTLOR: Elaine Marie Grove TRUSTEE: Elaine Marie Grove 6 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF DAUPHIN Before me, a Notary Public in and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared Elaine Marie Grove, known to me or satisfactorily proven to be the person described in the foregoing LEE ALEXANDER FRANK SPECIAL NEEDS TRUST, and acknowledged that She executed the same for the purposes therein stated, and subscribed and sworn to before me by and ,witnesses, this day of , 2012. IN WITNESS WHEREOF, I hereunto set my hand and seal on this day of 2012. My commission expires: Notary Public IN RE: ESTATE OF GRACE MARIE FRANK And THE GRACE MARIE FRANK TRUST ELAINE MARIE GROVE, TRUSTEE, PETITIONER IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS, ORPHANS' COURT DIVISION NO. 2011-00800 CIVIL ACTION -EQUITY CONSENT OF PROPOSED TRUSTEE Elaine Marie Grove, hereby consents to be and act as Trustee of the Lee Alexander Frank Special Needs Trust. Date: O ~d ia, By: arie rove 1210 4`h Street Enola, PA 17025 E CERTIFICATE OF SERVICE I certify that I am this w~ day of , 2012, serving a copy of the foregoing document upon the person(s) and in the manner indicated below, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure, by depositing a copy of same in the United States Mail at Harrisburg, Pennsylvania, with first-class postage, prepaid, as follows: Lisa Dees, Esquire Assistant Counsel Pennsylvania Department of Public Welfare Health and Welfare Building, 3rd Floor, West 7cn & Forster Streets Harrisburg, PA 17120 Caldw 1 & Kearns, P.C. C n BY~ ~ ~~ CALDWELL &KEARNS JAMES R. CLIPPINGER JAMES L GOLDSMITH A PROFESSIONAL CORPORATION OF CDUNSEL STANLEY J.A. LASKOWSKI ATTORNEYS AT LAW JAMES D. CAMPBELL, JR. DOUGLAS K. MARSICO CHARLES J. DEHART, 111 BRETT M. WOODBURN MICHAEL D. REED MICHAEL A. FARRELL THOM L, JR THOMAS M. FRATICELLI 3631 NORTH FRONT STREET 192&2001) GREGORY D. GEISS HARRISBURG, PENNSYLVANIA 17110-1533 THOMAS $. LEE CARL G. WASS ELIZABETH H. FEATHER (1937-2010) KAREN W. MILLER 717-232-7661 DOUGLAS M. OBERHOLSER FAX: 717-232-2766 RICHARD L KEARNS DAVID J. EVENHUIS RETIRED THEFIRMQCKLEGAL.NET 3anuary 20, 2012 VIA E-MAIL: rcoulson(a~ccpa.net & First Class Mail The Honorable Christylee L. Peck Cumberland County Courthouse One Courthouse Square, Room 405 Carlisle, PA 17013 RE: Estate of Grace Marie Frank Cumberland County No. 2111-0800 Your Honor: Enclosed please find Exhibit "E", Consent of the Pennsylvania Department of Public Welfare, which was missing from my Petition to Modify Terms of Trust to Create Special Needs Trust which was filed on January 13, 2012. Thank you for your attention to this matter. Very truly you~rjs,~'] tV . Ota~ ~~~~~ Elizabeth H. Feather Caldwell & Kearns, P.C. efeather(a~cklegal. net EHF:se Enclosure 11313-002/186200 t ' ~~ ~~, ;~~ t : ~. ~i COMMONWEALTH OF PENNSYLVANIA GOVERNOR'S OFFICE OF GENERAL COUNSEL January 9, 2012 Hard Copy by Mail Elizabeth H. Feather, Esquire CALDWELL & KEARNS A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3631 North Front Street Harrisburg, PA 17110 Via Email-efeather @clclegal.net Re: Petition to Modify and Create the Lee Alexander Fral~lc Special Needs Trust Dear Attorney Feather: I have reviewed your petition to modify the trust created by the Grace Marie Frank Last Will and Testament. I have also reviewed the draft copy. of the Lee Alexander Fras~lc Special Needs Trust (SNT) that will replace Item VI (a) of the decedent's will in its entirety. The Department of Public Welfare (Department) has no objections to the petition or the creation of the SNT. The disabled beneficiary's assets that fare used to fund the SNT will not be considered an available resource in determining Lee Alexander Frank's eligibility for Medical Assistance. If Mr. Frank has other assets that are not part of the SNT, the County Assistance Office ("CAO") may determine that he is not eligible for Medical Assistance. liz order to assist the Department in making its determination of Medical Assistance eligibility, please provide to the CAO (with a copy to me) the documentation regarding the funding of this SNT and any subsequent additions to the SNT. Thank you for your attention and cooperation with the Department. If you have any questions, please feel free to contact me. c: Susan Naylor Tammey Hughes Susan Geiger Very truly yours, Lisa B. Dees .Assistant, counsel OFFICE OF CHIEF COUNSEL ~ DEPARTMENT OF PUBLIC WELFARE 3RD FL. WEST, HEALTH & WELFARE BLDG. ~ 7T" & FORSTER STREETS ~ HARRISBURG, PA 17120 Ph: 717-783-2800 ~ Fx: 717-772-0717 ~ www dnw state ~a us ~ II~ I~ ~ ~I_ ~~-