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The Ticket to Work and Work Incentives Improvement Act (1999) ensures health care coverage, employment preparation, placement services, Medicaid coverage (even while the disabled individual is employed, if desired), and “tickets to work,” which provide access to services needed to maintain employment (NASHIA, 2003).

PATIENT AUTONOMY ISSUES

Along with legal and financial considerations that should be attended to are issues related to the patient’s autonomy. Decisions must be made relating to medical treatment, management and use of funds and property, and even designating caregivers for the injured individual’s dependent children. Some of these decisions will need to be made immediately, and some over time. We strongly urge you to seek the advice of attorneys specializing in legal, financial, and long-term issues specific to brain-injured individuals and their families.

Guardianship

A guardianship is a legal relationship between the disabled individual (ward) and a court-appointed individual (guardian). The guardianship is established once a judge determines that the disabled individual is “incompetent,” based on medical documentation. The guardian is given the duty and right to act on behalf of the injured person to make personal, legal, and financial decisions that may affect all aspects of the injured person’s life.

Although appointing a guardian can be difficult and emotional for families, it should be determined as soon as possible whether this is the best option. Family members should consult with their attorney, physician, social worker, and proposed guardian for help in making this determination.

Power of Attorney

This is a written legal agreement by which one person (principal) appoints another person (agent) to act on his or her behalf. The agent is given either restricted or broad authority to make decisions ranging from medical treatment to financial decisions. A power of attorney is similar to a guardianship, except that it typically

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