[Name]
[Date]
Page [#]
§3.01RETAINER LETTER
Contributed by Joseph A. Cipparone of Cole-Chu, Cipparone & Zaccaro, PC
in New London, CT.
Author’s Comments:This retainer letter clarifies the work to be performed by the law firm and the fees charged for services connected to Medicaid planning. It is based on an adult with financial responsibility and the client’s power of attorney signing this letter. The letter is for representing a disabled parent whose spouse has died. If the parent is able to sign, the letter should be revised and addressed to the parent being represented. The retainer letter requires a one-time, up-front fee for Medicaid planning services.
Last revision:September 15, 2011.
Retainer Letter
[Name and Address]
Dear :
Thank you for asking [Firm Name] to assist your [relationship] with pursuing her/his rights under federal and state lawto obtaingovernment benefits and related estate planning and tax matters. Connecticut rules require us to give you written confirmation of the scope of our representation and the basis of our charges.
Based on our meeting of ______, 20__, we will provide elder law advice and prepare and file an application for Medicaid benefits for your [relationship],[Name]. On ______, 20___, we will file Application Part 1: Assistance Request Form (W-1) with the Department of Social Services to start the Medicaid application. Our next step is to complete the Application Part 2; Special Eligibility Determination Document (Form W-1F) including the any and all documentation needed. In addition, we will
a.Evaluate and develop recommendations for further action to make maximum use of Medicare, Medicaid, and other public entitlements and to conserve your [relationship]’s assets;
b.Prepare any deeds, trusts, wills, powers of attorney, or other instruments necessary to effectuate plan recommendations, as directed;
c.Prepare and file the Medicaid application. Our work under this retainer agreement does not include the appeal of a denial of Medicaid assistance by the Connecticut Department of Social Services. Any such appeal will require a new retainer agreement.
We will perform these tasks with care and diligence. We will try to apprise you of the potential risks of proceeding with different courses of action, but you understand that nothing in this field is absolutely certain or insulated from changes in the law or DSS policy. We can therefore make no guarantees as to any particular outcome.
The charge for the work described above will be $______, which you have paid from your [relationship] funds and constitutes a non-refundable fee. Wewill also charge you for any title searches, and recording or filing fees incurred in connection with this representation. We reserve the right not to perform any services, or incur any costs, beyond what is covered by this retainer agreement.
This agreement may be terminated by you, your [relationship], or by us at any time, and will cease if your [relationship] passes away. Upon termination, our responsibility shall only consist of returning your records.
As we discussed, we will be representing your [relationship]in this legal matter. We agree to hold all communications and information provided to us by you and your [relationship]in total confidence, except as authorized and directed by either of you. We will, upon your direction, communicate with other members of your family or others regarding this matter.
Please call me if you have any questions about our billing policies or the scope of our representation. If this letter accurately describes your understanding of the scope of our representation and the basis of our charges, please sign and return the enclosed copy of this letter.
Very truly yours,
[Attorney’s Name]
Accepted:
[CLIENT’s Name]
By______Date: ______
[POA’s Name]
Her Attorney-in-Fact