When does medical exspences STOP

[glessen]

my step daughter will be 18 this yr. the CS order does not end until June of '07. She may need some major dental work done for all of a sudden she has a problem with her mouth and need major surgery and braces. My husband thinks it is cosmedic. But anyways if we have to pay half of it for our order states we pay half of all medical and dental exspenses. But if this falls into cosmedic we owe nothing, right??? and from what we are told by mother this will go on for about two to three years for all this work to be done. My insurance on her will end June of 07 and that is when the order stops. Does that mean if we have to pay on this major mouth work that ends in june also? Please help. For my step daughter works full time but still goes to school part time.

[socrateaser]

Thanks in advance.

[glessen]

I am sorry for that.
     
Illinois court order to provide medical insurance until June of 2007.
Court order to pay half of all exspenses that insurance does not cover
   on medical and dental until June of 2007.
Needing major mouth work done, but cost of it will not end until two to
   four years after support ends.
Still finding out if this is a medical issue or just cosmedic.

1. Does my exspense end when the order ends in June of 2007?

2. Daughter will be eighteen in Sept. of this year, does that effect the    
       the end of support and her working full time since last year?

[socrateaser]

>1. Does my exspense end when the order ends in June of 2007?

The answer depends on when your expense is actually incurred. If a procedure is recommended prior to the termination of the order, but neither parent has actually authorized the procedure, by way of a binding contract, or if the service provider has not begun perform the procedure, then yoiu would no longer be liable.

Examples:

1. Orthodontist says, "We will probably need to break the child's jaw and insert a prosthetic if the child's jaw does grow sufficiently to accomodate the new teeth, or we can pull some molars to make enough space for the remaining teeth," and the parent says, "ok," and then the ortho pulls the teeth. Then the support order terminates, and the ortho says, "That wasn't enough -- we need to break the jaw," then you would NOT be responsible for the next surgery, because the ortho did what he/she thought would be necessary in preference to the other more drastic choice.

But, if the ortho says, "We will pull some teeth now and we will break the jaw later if that doesn't work," and the parent says, "ok," then under the same circumstances, you would be liable, because the parent was authorizing the entire procedure at the moment that the ortho recommended it.

Yes, the difference between "or" and "and" is all it takes to change the facts.

As a practical matter, however, unless someone has it in writing as to the exact proposed course of action, then it would be extremely difficult to prove things one way or the other. Frankly, in such a case, I can see the ortho writing a note after the fact that the CP would introduce in court stating that the entire procedure was authorized in advance, so as to better secure payment, and there wouldn't be anyway for you to prove that was not the ortho's original prescription.

Unless, you were able to get it in writing now. Obviously if you have no access to the service provider, then you can't obtain a response that might help your case later on. But, if you can get access, then a well thought out letter that received a response might inadvertantly provide you with the proof you would need to get things in your favor later on.

I have encountered the above EXACT set of circumstances before, and the parent was saved by the ortho who stated that the entire procedure was not "dentally necessary," at the time the letter was written, but that it "might" become so in the future.

So, there, the word "might" made all the difference. That was speculation. If the ortho had said "will be necessary," that would no longer be speculation and if the other parent authorized the procedure, then that would bind both parents to pay for it.

This is a real hair splitter.

>
>2. Daughter will be eighteen in Sept. of this year, does that
>effect the the end of support and her working full time since last
>year?

Whether a child is emancipated is a specific issue of State law, and I don't know the rules in your jurisdiction. Frequently the rules are pretty vague and open to the court's discretion.

Example: in CA, a child who is 18 and graduated H.S. or 19 is emancipated, unless the child is physically or mentally incapable of supporting his/herself (presumed to mean reasonably capable of working full time for minimum wage).

However, in NY, a child can move out of the parent's home at 18, be ruled emancipated by the court, and then move back into the parent's home at 20, and the court will "unemancipate" the child and order support again -- until the child reaches 21.

And, in NJ (as many of my long term posters here will sadly acknowledge), the court can continue to order support of an adult child F O R E V E R, as long as it finds it fair that the parent support the child.

Moral of this last scenario is that anyone who has children while living in NJ does so at his/her peril -- it is a potentially a financially life threatening decision/accident.

I don't have time to investigate the IL rules at the moment, so you'll need to talk to a local attorney if you want a definitive answer.

[glessen]

Court order state half of unpaid medical exspenses.
Found out ortho work being done is cosmedic, and if she did not have it
    done her health would not be affected.

My question's

1. what is "Medical"?
2. Does vision fall under medical?
3. Does ortho fall under medical?
4. Does cosmedic fall under medical?
5. Does dental fall under medical?

[socrateaser]

>My question's
>
>1. what is "Medical"?

Ordinarily I would ask you to post the exact text of the order. But, as you have specifically raised the issue of the word "medical," I'll assume that's exactly how the order reads.

GENERALLY (but not always), "medical" means necessary services rendered by a medical professional. It does not include "dental" or "vision." MOST modern orders will use the phrase "reasonable healthcare expenses," so as to broadly cover every possible issue.

If your order doesn't have this sort of coverage, then you may have an out. But, it depends on whether a statute or case law in your jurisdiction defines "medical" more broadly than I am here. If no statute or case law exists, then you are within your rights to refuse, because "medical" doesn't mean dental or vision (although a dental procedure, e.g., jaw reconstruction due to traffic collision, or a corneal implant, because of a laceration of the cornea would be exceptions, because the procedures are "medically necessary").

Filter every question through the phrase "medically necessary," i.e., prescribed by a licensed "medical" professional, as the recommended course of action/therapy/care.

>2. Does vision fall under medical?

Depends. If it's recommended by an optometrist, then no. If recommended by an opthomologist, then yes. The distinction is that one is a licensed physician (medical professional), while the other measures the accuracy of your vision and sells glasses (not that I have anything in particular against optometrists -- but they're not eye "doctors."

>3. Does ortho fall under medical?

No. This is "dental" unless medically necessary or your state broadly defines the word "medical."

>4. Does cosmedic fall under medical?

No. But, if your state broadly defines the term, then it could, because say the child was disfigured in a car crash and a psychologist found that she was extremely depressed, such that cosmetic surgery would likely remedy the depression and anxiety of the disfiguring injury. Suddenly, it's medically necessary.

It's a slippery slope -- which is what modern orders usually say "reasonably necessary healthcare," because it covers everything.

>5. Does dental fall under medical?

See above.

[MixedBag]

my order is old.

And my judge said that he would interpret what is covered broadly so medical, dental, vision, perscriptions, and mental (and probably some more) would be considered by the simple word "medical".

[glessen]

This is so damn confusing. Forgive me and me french.

Aug. of 2004 Petition for entry of Judgment states I qoute from paper," 1. The judgment herein requires that each party pay one half of any medical bills incurred on behalf of the minor children of the parties that are not covered by insurance."

Oct of 2004 Support order
CP kept 4 yrs of medical bills and all of a sudden wanted her half back. Fine I can understand that I would want it to. (But I would want them sooner then four yrs down the road when it totaled over 2K)
In support order and every order he has ever recived from time of divorce in 1996
I quote" The obligor shall carry health insurance for the above named children and pay 50% of uncovered health exspenses. All necessary documentation for the use of insurance shall be provided to the obligee immediately."

This ortho thing is because she has an under bite. And the ortho has told us just yesterday that this is not medically needed it is just cosmedic to have straight teeth.

We were told nothing of this under CP sent us bills.

[socrateaser]

>This is so damn confusing. Forgive me and me french.
>
>Aug. of 2004 Petition for entry of Judgment states I qoute
>from paper," 1. The judgment herein requires that each party
>pay one half of any medical bills incurred on behalf of the
>minor children of the parties that are not covered by
>insurance."
>
>Oct of 2004 Support order
>CP kept 4 yrs of medical bills and all of a sudden wanted her
>half back. Fine I can understand that I would want it to. (But
>I would want them sooner then four yrs down the road when it
>totaled over 2K)
>In support order and every order he has ever recived from time
>of divorce in 1996
>I quote" The obligor shall carry health insurance for the
>above named children and pay 50% of uncovered health
>exspenses. All necessary documentation for the use of
>insurance shall be provided to the obligee immediately."
>
>This ortho thing is because she has an under bite. And the
>ortho has told us just yesterday that this is not medically
>needed it is just cosmedic to have straight teeth.
>
>We were told nothing of this under CP sent us bills.

OK, well, I don't see the word "medical" anywhere in the above order. I see the word "health." Which means "reasonable healthcare costs." So, the obligor is on the hook for 50% of all uncovered reasonable healthcare costs, and means everything from a heart transplant to a box of dental floss.

Purely cosmetic dental orthodontia is NOT a reasonable healthcare cost, if you have it in writing from the orthodontist that the care is not "dentally necessary," but is only cosmetic.

If you don't have it in writing just like I've stated above, then you will end up having to pay for it, because the judge will bend over backwards to interpret the order to cover the child's braces.

I hope that's clear enough for you. This shouldn't be confusing at all.

[nikilax]

I had an underbite and actually underwent surgery for it.  However, my parents were told from the time that I was two, that it would eventually require surgery as my lower jaw had grown faster than the upper.  I had braces all through highschool.  I had the surgery to move my jaw the summer before my senior year of highschool and one surgery thereafter to fix something else that had occured after my braces came off.  So, this was all done within a space of a year.  Incidentally, they also took out my top to wisdom teeth during the first surgery and then the bottom ones during the second surgery so they killed a couple birds with two stones.

I would see if a dental surgeon may have a second opinion as i went to an oral/maxillofacial surgeon to assess my condition.